Background: Rational use of drugs is an essential element in achieving quality of health and medical care for the patients and the community. However irrational use of medicines is still a worldwide problem. Objective(s): Assessment of drug use in family health facilities in Alexandria, through application of drug use indicators including; prescribing indicators, patient care indicators and health facility indicators. Methods: A cross-sectional descriptive study was conducted in eight randomly selected family health facilities (FHFs) distributed in four randomly selected health care districts in Alexandria Governorate. An observational checklist and interview questionnaire designed based on World Health Organization/ International Network of Rational Use of Drugs (WHO/INRUD) drug use indicators and WHO guide to good prescribing were used for data collection. 600 patients were interviewed, and 240 consultation sessions and drug dispensing processes were observed. Results: The most deficient drug use indicators were the patient care indicators, as none of the drugs were adequately labelled, the average consultation time was 5.7 ± 2.9 minutes (compared to the optimal value ≥ 20 minutes) and the mean % of adequate patients' knowledge was 56 ± 49.7. As regards health facility indicators, availability of key drugs in stock was unsatisfactory, as the mean % was 66.3 ± 47.6. On the other hand, prescribing indicators were considered satisfactory. Conclusion: We may conclude that patient care indicators were the most deficient among drug use indicators, especially labelling of drugs, consultation time and patients' knowledge, in addition to availability of key drugs in stock. We may recommend that rational drug prescribing should be included in the national practice guidelines of family practice.