Purpose The purpose of this paper is to assess the quality practices of European pharmaceutical manufacturers to determine the level of readiness of this industrial sector to implement and/or sustain lean manufacturing (LM). Design/methodology/approach An assessment framework developed by Al-Najem et al. (2013) was adapted to evaluate how ready European pharmaceutical manufacturers are to implement and/or sustain LM. Therefore, the lean readiness (LR) level of these organisations was assessed through six quality practices related to LM. These included: processes, planning and control, human resources, top management and leadership, customer relations, and supplier relations. One research question and three hypotheses were formulated and tested using a combination of descriptive statistics and non-parametric Mann-Whitney tests. Data were collected through a survey questionnaire distributed to 310 European pharmaceutical manufacturers and responded by 37 of these organisations. Findings Overall, the results of this study indicate an inadequate level of LR for the participating firms. Simultaneously, it was concluded that factors such as company size, type of relationships with suppliers and ISO 9000 certification do not have an effect on the quality practices, and hence LR level, of European pharmaceutical manufacturing organisations. Practical implications This study provides crucial information regarding the LR level of European pharmaceutical manufacturers, which can now be aware of the areas in their practices that require further improvement towards a successful lean journey. Simultaneously, organisations in the pharmaceutical sector that intend to implement LM can consider the results of this study and evaluate their readiness level. Managers can, therefore, refer to this research and use it as a platform to take better decisions regarding what quality aspects of their operations need to be enhanced to successfully deploy or sustain a lean strategy. Originality/value This research is one of the very few studies that have focussed on evaluating whether the European pharmaceutical manufacturing industry is ready to successfully implement or sustain LM. Therefore, this research expands the limited existent body of knowledge of LM in this industry.