Polypharmacy is one of the most significant health issues associated with increased occurrence of Potentially Inappropriate Medications (PIMs), that impacts the disease burden and healthcare costs. There is currently no multicenter cross-sectional study in Libya that evaluated the prevalence of polypharmacy and PIMs used by older patients. Prescriptions from two governmental hospitals and two private clinics were retrospectively explored. Patients' details, number of drugs per prescription, and other drug details were collected. Beers criteria of 2019 were used to identify the presence of PIMs and ultimately the prescribing suitability. Prescriptions from hospitals contains significantly higher polypharmacy than in clinics (75.3% vs. 48.8%, P=0.012). In contrast, the presence of PIMs in the private clinics was significantly higher than in hospitals (46.4% vs 36.3%, P=0.022). Medications used to treat chronic disorders like diabetes, dyslipidemia, and hypertension were frequently prescribed to patients with polypharmacy in both health settings. Drugs for gastrointestinal disorders and antihistamines were commonly identified as PIMs for both care settings. We confirmed the presence of polypharmacy associated with PIMs, especially for patients with cardiovascular disease, or diabetes. Efforts should be made to improve the prescription quality of older patients.