Background: There are few studies of community pharmacy footfall and activity in the existing literature, especially by direct observation. Objective: To describe the characteristics of counter interactions between pharmacy staff and customers. Method: Structured observation of all interactions between pharmacy staff and customers across the weekly opening hours of five pharmacies diverse in location and ownership. Key findings: Three-quarters (76%) of observed interactions were associated with prescriptions, but a significant minority accessed cognitive services. Conclusions: Dispensing was the primary activity across the diverse range of pharmacies. Reasons for visits are diversifying into advice and services, particularly among younger users.