Background: Chronic kidney disease is a major public health issue which requires complex pharmacotherapy. This study was aimed to evaluate drug utilization pattern in chronic kidney disease patients. Method: A prospective observational study was conducted at Nephrology department in Rajiv Gandhi Cooperative Multispecialty hospital, Palakkad for a period of 6 month from July 2022 to January 2023. Medications were assessed by using WHO prescribing indicator and classified in the basis of Anatomic Therapeutic Classification. Results: A total of 120 patients were examined. According to the ATC categorization, out of a total of 921 medicines, cardiovascular drugs were most frequently administered. The average number of drugs per prescription was 7.6%. 11.3% of those medications were prescribed by their generic names. 49.9% of drugs were prescribed on the accordance with essential medicine list. The patient prescribed with an injection was 46% and patients prescribed with antibiotic were 25.5%. Poly pharmacy was executed in 86% of patients. Antihypertensive drugs were most frequently recommended class of drugs followed by hematopoietic drugs and vitamin and minerals in therapeutic wise classification of drugs. Conclusion: Of all drugs prescribed, cardiovascular drugs were commonly prescribed and prevalence of poly pharmacy is high in patients due to co morbidities.