PURPOSE: Measurements of patient satisfaction help to assess the performance of health service provision and predict treatment adherence and outcomes. This study aimed to assess human HIV/AIDS patients' expectation of and satisfaction with the pharmaceutical service delivered at Gondar University Referral Hospital, Ethiopia. PATIENTS AND METHODS: An institution-based cross-sectional study was performed from May 11 to 25, 2015. A total of 291 patients living with HIV/AIDS were included using a simple random sampling method. Data were collected using structured questionnaires measuring expectation and satisfaction of respondents using a Likert scale of 1-5 through face-to-face interviews. The data collected were entered into and analyzed using Statistical Packages for Social Sciences. Comparison was made between those respondents who lived in and outside the town. RESULTS: The overall mean expectation and satisfaction of respondents toward pharmacy setting and services were 3.62 and 3.13, respectively. More than half (56.1%) of the participants were dissatisfied with the comfort and convenience of waiting area and private counseling room. Similarly, 69.3% of the respondents claimed that pharmacy professionals did not give information about side effects and drug-drug and drug-food interactions of antiretroviral medications. There was a statistically significant difference between respondents who live in and outside Gondar town in overall expectation (t=3.415, P=0.001) with the pharmacy setting and services. CONCLUSION: In this study, the overall satisfaction level of respondents with pharmaceutical service (pharmacy setting and services) provided at Gondar University Referral Hospital was found to be low, while the overall respondents' expectation from the pharmaceutical services were exceedingly high. The hospital should implement good dispensing practice systems in relation to the services and continuing professional development to professionals in order to improve the satisfaction of patients.