Emergency department is a place where the patients need immediate care and treatment. Hence, the rationality of choosing the drugs in the limited time frame is very important. The objective of this study was to assess and evaluate the rationality of prescribing pattern in the emergency department. Data was collected from the case sheets of the patients who visited our hospital emergency department in the duration of the study. Out of 322 patients, 177 (54.96%) were males and 145 (45.03%) were females mostly belonging to 51-60 (26.7%) and 41-50 (23.29%) age groups. The most common reasons for admission were road traffic accidents, respiratory problems, abdominal pain, workplace injury, chest pain, high grade fever, loose stools, poisoning, cerebrovascular accidents (stroke), animal bite, foreign body removal and infection of eye and ear. The most commonly prescribed drugs are i.v fluids (316), Pantoprazole (302), Ondansetron (192), Paracetamol (174), Tramadol (97), Lignocaine (83), Drotaverine (81), Tetanus toxoid (80), Cephalosporins (74), Flouroquinolone (69), Budesonide (58), Salbutamol (58), calcium channel blockers (29), Diclofenac (28), Metronidazole (26), Hydrocortisone (25), Aspirin (22), Clopidogrel (22), Angiotensin Receptor Blockers (18) and Isosorbide dinitrate (18). Percentage of drugs prescribed by generic name is 41% and percentage of drugs prescribed from list of essential drugs is 68% which is low compared to the WHO ideal value of 100%. Physicians should be encouraged to prescribe generic drugs from essential medicine list as recommended by WHO which will help the hospital pharmacists to avoid confusions in dispensing and duplication of products and will also help the patients by reducing the cost of therapy.