The debate about extending the role of pharmacists in health care is growing in recognition of the ongoing difficulties experienced by many public sector services. The perceived accessibility and confidentiality of pharmacists makes them particularly attractive to patients for the management of health problems such as sexually transmitted infections (STI) that may lead to stigmatization. Despite growing interest in the subject, there are few documented analyses of the role of pharmacists in low-income countries. In Ghana, pharmacists are acknowledged by the government to be the preferred option for people seeking treatment for STI. A study was conducted to investigate the current role played by pharmacists in Greater Accra Region in the management of STI. On the basis of these findings, training schemes were developed, implemented and evaluated. This paper presents the findings of this operation-research and considers their implications for deciding to what extent and in what way pharmacists should be involved in managing STI in Ghana and other similar country settings. These findings suggest that pharmacists have a crucial role in effective management of STI, particularly in the management of urethral discharge. They may need to limit their management of genital ulcer to referring customers to laboratories and medical practitioners. They also represent a currently under-utilized opportunity for preventive activities. Regulation and quality assurance issues need to be addressed by both pharmacy and medical professions.