Antibiotics are among the most commonly prescribed drugs, used in human medicine. They are usually life saving medications. Antibiotics/antimicrobial resistance is the ability of microbes to resist the effects of drugs- that is, the germs are not killed, and their growth is not stopped. Irrational antibiotic use plays a big role in the development and spread of antibiotic resistance. OBJECTIVES Assessing practitioner’s prescription practices for adults above 18 years old with different diagnoses at KCMC consultant referral hospital outpatient departments in Moshi, Kilimanjaro region, Tanzania from June - July 2016. METHODOLOGY This cross sectional descriptive hospital based study was conducted at KCMC consultant referralhospital medical OPD and casualty from June to July 2016. A convenient non probability sampling technique was used to get participants. Two interview questionnaires were used to collect key information, one for the doctor and the other for the patient. RESULTS Antibiotic prescription was at a high rate (77%). Majority (62.6%) being prescribed before results of investigations ordered. Penicillin (48.7%) being the major group of antibiotics prescribed. Medical officers prescribing the most (64.5%). None of the clinicians used any guideline to prescribe. CONCLUSIONS Antibiotic prescription is at a high rate at KCMC, majority being prescribed prior to investigation results, medical officers accounting for most of the prescriptions and none following any specific guideline being kept either by the hospital or government.