BACKGROUND: Inappropriate prescribing of antibiotics is a global problem. We assessed the prescribing patterns of antibiotics in three public primary healthcare centres (PHCCs) in Maseru, Lesotho. OBJECTIVES: A cross-sectional point prevalence survey was employed using patients' prescription booklets from October 2022 to December 2022. METHOD: Antibiotics were categorised according to the World Health Organization (WHO) AWaRe classification and assessed by Defined Daily Dose (DDD)/100 outpatients/day to measure relative consumption of each antibiotic as a percentage of total consumption, Access-to-Watch index (AW-I) and Amoxicillin Index (A-I). RESULTS: Of the 624 participants (median age 35 [interquartile range {IQR}: 45-26] years), 71.5% ( CONCLUSION: High consumption of Access-group antibiotics was observed. The Watch group's antibiotic use, particularly erythromycin, requires the implementation of stewardship programmes. Results may be a baseline for establishing antibiotic stewardship in Lesotho's PHCCs. CONTRIBUTION: Our study addressed the scarcity of data on antibiotic prescribing patterns in PHCCs in Lesotho using the AWaRe classification system recommended for monitoring antibiotic prescribing and promoting rational use.