Key Points Question What is the availability of naloxone at pharmacies in Philadelphia, Pennsylvania, 3 years after the implementation of a statewide standing order in Pennsylvania allowing pharmacists to dispense naloxone without a prescription? Findings This survey study of 418 pharmacies in Philadelphia found that only one-third carried naloxone nasal spray and many also required a physician’s prescription, including pharmacies in communities with the highest rates of opioid overdose death. Meaning Efforts to strengthen the implementation of naloxone access laws and better ensure naloxone supply at local pharmacies are warranted, especially in localities with high rates of opioid overdose death.