Objectives  The objectives were to explore the processes involved in a pilot Medicines Use Review (MUR) service in Auckland, New Zealand, and to investigate service providers' and patients' views of the service. Methods  Semi-structured interviews were conducted with pharmacists (n = 5) and patients (n = 27) who took part in the pilot. Key findings  Pharmacists saw the pilot as an opportunity to provide an improved service and as a professional development exercise. Patient recruitment targets were viewed as achievable; however, a high number of patients declining, delays in MUR training and a lack of eligibility of some patients impacted on the number of patients recruited. In delivering MURs, a lack of available staff and time was a key issue identified by pharmacists. Patients reported they were happy to take part in the MUR and were comfortable having the pharmacist visit them at home. Overall levels of satisfaction with MUR delivery were high. Key benefits reported by patients included improved understanding of their medication and an enhanced relationship with their pharmacist. Pharmacists reported that the review had improved outcomes for some patients, with home visits providing beneficial environmental insights. Enhanced professional practice and improved relationships with patients were also cited. Conclusions  Findings from this study have confirmed the complexity of MUR delivery, and the mixed outcomes for patients and pharmacists. Although patient benefits such as increased knowledge and confidence regarding medicine-, and health-related, issues were identified, logistical issues were a challenge. Further investigation of the longer-term health gains of MURs for patients is required.