The work reported here aimed to quantify the involvement of medicines counter assistants (MCAs) in the United Kingdom in the sale of deregulated medicines and to provide insights into their role and experiences in this process. Non-participant observation for five days in each of 10 community pharmacies was used in conjunction with interviews and focus groups with MCAs working in these pharmacies. It was found that MCAs dealt with 84 per cent of the deregulated medicines requested, without the formal involvement of a pharmacist. MCAs dealt with 96 per cent of requests for aciclovir, and 100 per cent of requests for cetirizine, Canesten Combi, famotidine, hydrocortisone cream and topical ibuprofen without the intervention of a pharmacist. MCAs viewed themselves as front-line health care workers carrying out an important role in consumer care. However, in instances where difficulties were encountered during an MCA-consumer interaction, MCAs knew and appreciated that they had the backup of a pharmacist to whom to refer. MCAs identified a number of dilemmas which impinged on their ability to ask questions and provide advice to consumers requesting deregulated medicines. Given these findings, the current role, workload and experiences of MCAs merit more attention than has hitherto been accorded in pharmacy practice and health services research.