A system of shared pharmaceutical services between two small, rural hospitals is described. A contractural agreement was established between a 140-bed hospital and a 40-bed hospital located 15 miles apart in a rural area of eastern Kentucky. The larger hospital provided comprehensive pharmaceutical services to the smaller hospital for a monthly fee. Procurement of i.v. fluids and supplies was a function of the larger hospital; other drugs and supplies were procured separately. The director of pharmacy at the larger institution also served as the director at the small institution. Staff pharmacists rotated between the two hospitals. Supportive personnel were assigned permanently to each hospital. The shared service arrangement reduced costs associated with the implementation of comprehensive pharmaceutical services and made it easier to recruit and retain skilled pharmacy personnel.