Initiatives related to reverse logistics are increasingly common in companies that produce tires, lubricating oils, batteries, and electronic equipment, among others. In the pharmaceutical sector, reverse logistics is also relevant, contributing to reduce medication exposure to other people and the environment. Thus, this research seeks to find out which practices related to reverse logistics are used in 13 hospitals in the state of Rio de Janeiro. Regarding the methodological procedures, this research is supported by interviews with those responsible for disposing of medicines from hospitals, and the best practices were ranked using the analytic hierarchy process (AHP) method. Among the main difficulties for performing Medicine Reverse Logistics practices in hospitals, the absence of a standard process for medicine disposal and medications held by nurses or satellite pharmacies-for being out of control-stand out.