Class of 2007 Abstract / Objectives: To describe the after-hours medication needs in rural hospital pharmacies which are closed during the night. Methods: Entries in a night medication log from a 60 bed rural Arizona hospital that closed for 12 hours at night were collected. Complete entries were assigned a night of the week, a month of the year, and a two hour time period. Data was collected from April 1, 2005 to March 30, 2006. Entries were sorted into groups, counted, and ranked. Groups were compared using student’s t-test. The top 200 drug products ranked by quantity was recorded for a trial of fit into a night formulary. Results: The night medication log contained 4986 complete entries accounting for 669 individual drug products. Non-pharmacy staff entered the pharmacy after-hours 2070 times and removed 10449 drug dosage units. No significant difference in night medication need was found between summer and winter month or weeknight and weekend night. Early night need was significantly different than late night need (p = 0.01). The top 200 drug products covered 83.3% of the medication quantity need of the hospital. Conclusions: The study found that a large percentage (83.3%) of the night medication need could be accessible from a 200 item night formulary. Seasonal and weekend differences were non-significant with only time of night differences being significant. These results could justify the extending of current hours or establishment of a night formulary to decrease entrances into the pharmacy when a pharmacist is not on duty.