Shazia Qasim Jamshed,1 Mohamad Izham Mohamad Ibrahim,2 Mohamad Azmi Hassali,3 Adheed Khalid Sharrad,4 Asrul Akmal Shafie,3 Zaheer-Ud-Din Babar5 1Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan Campus, Pahang, Malaysia; 2College of Pharmacy, Qatar University, Doha, Qatar; 3Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Penang, Malaysia; 4College of Pharmacy, University of Basra, Basra, Iraq; 5School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand General objective: To evaluate the understanding and perceptions of generic medicines among final-year Doctor of Pharmacy students in Karachi, Pakistan. Methods: A 23-item survey instrument that included a question on the bioequivalence limits and Likert-type scale questions regarding the understanding and perceptions of generic medicines among the students was executed. Cronbach’s alpha was found to be 0.62. Results: Responses were obtained from 236 final-year Doctor of Pharmacy students (n=85 from a publicly funded institute; n=151 from a privately funded institute). When comparing a brand-name medicine to a generic medicine, pharmacy students scored poorly on bioequivalence limits. More than 80% of the students incorrectly answered that all the products that are rated as generic equivalents are therapeutically equivalent to each other (P<0.04). Half of the students agreed that a generic medicine is bioequivalent to the brand-name medicine (P<0.001). With regard to quality, effectiveness, and safety, more than 75% of the students disagreed that generic medicines are of inferior quality and are less effective than brand-name medicines (P<0.001). More than 50% of the students disagreed that generic medicines produce more side effects than brand-name medicines (P<0.001). Conclusion: The current study identified a positive perception toward generic medicines but also gaps in the understanding of generic medicines. Pharmacy students lacked a thorough understanding of the concepts of bioequivalence. Pharmacy academia should address these issues, which will help build confidence in generic medicines and increase the generic medicine use in Pakistan. Keywords: safety, curriculum, efficacy