Background: Maintaining privacy during patient counseling is critical, especially with respect to sensitive client issues. In general, community pharmacy practice in Saudi Arabia is considered substandard in several aspects, particularly with respect to the privacy it offers to pharmacy clients. However, to date, maintenance of privacy in Saudi Arabian community pharmacies has not been studied using a practical, measurable method. Objective: This study investigates the level and quality of privacy offered by community pharmacies in Madinah, Saudi Arabia. Methods: This study randomly selected 80 pharmacies, which were visited by a simulated client and a simulated customer who were instructed to engage in a standard scenario. During each pharmacy visit, the simulated client asked the on-duty pharmacist about the correct use of a medication intended for a vaginal disease. The simulated customer pretended to look for a nonmedical product on the shelf nearest to where the client-pharmacist consultation took place and observed whether the conversation was audible. Further, privacy facilities and pharmacist behaviors were documented. Results: A designated consultation area was found in only one pharmacy; however, it was not used and not designed as separate from the pharmacist's counter. Although a designated waiting area was found in the same pharmacy, it was located too close for privacy to be maintained. Other physical measures of privacy were unavailable in all the other pharmacies. Regarding the simulated client-pharmacist consultation, the conversation was audible to the simulated customer in 63% of the pharmacies. Further, in most of the visited pharmacies, there was only one pharmacist on duty. Finally, a female pharmacist was found in only one pharmacy. Conclusions: The study concludes that a critical insufficiency in privacy exists in community pharmacies in Saudi Arabia. It reveals that most pharmacies must be infrastructurally redesigned to provide acceptable privacy levels. Further, the number of