Appropriate medicine dispensing is very fundamental for optimum medicine use in the management of HIV/AIDS patients. However, there is dearth of knowledge about medicine dispensing pattern in the management of HIV/AIDS patients in North-Central Nigeria. This study assessed the medicine dispensing pattern in the management of HIV/AIDS patients at public health facilities in a North-Central State, Nigeria. This multi-center study was conducted in 7 eligible public health facilities. It comprised exit observational checks of medicines dispensed to 780 eligible HIV/AIDS patients, data abstraction from their medical folders and in-depth interviews of seven eligible dispensers using a pre-tested structured interview guide. Descriptive statistics were used for quantitative data analyses while in-depth interviews were audio-taped, transcribed verbatim, analysed and developed into ethnographic summary with illustrative quotes. Of the 1828 medicines that were dispensed, antiretroviral medicines constituted 58.9% of which Zidovudine/Nevirapine/Lamivudine as a fixed dose combination was the most dispensed while co-trimoxazole was the most dispensed non-antiretroviral medicine. Also, 96.5% of the patients were on first line ARVs regimen; 55.3% received co-trimoxazole preventive therapy and 3.5% received artemisinin-based combination therapy. One-third of dispensed medicines were inadequately labelled with regards to the name of the medicines, the dispensed quantity and the strength of the medicines. The study also revealed that six out of the seven dispensers practiced generic substitution. Dispensing pattern of medicines in the management of HIV/AIDS patients at public health facilities is below optimal regarding labelling information. Periodic training of dispensers on standard dispensing practices is recommended.