Essential medications are those that meet the people' basic needs for medical care. The public's health may be seriously impacted by necessary medications of poor quality. Therefore, the purpose of this study is to evaluate the standard of necessary medications that are offered in Nepal's public health care facilities. Using a lottery, 62 health institutions spread over 21 districts, representing all seven provinces of Nepal, participated in a cross-sectional descriptive study. Participants were proportionately chosen from each of the three ecological regions—the Terai, Hill, and Mountain—for the study. Using a random number generator, the health facilities in the given districts were selected. The head of the health center was interviewed in person using a structured questionnaire. Using observation checklists, all information regarding storage conditions was documented. A computerized device was used to measure the humidity and temperature. Likewise, twenty distinct generic medications were gathered for quality assessment. After being imported into Epidata version 3.1, the data were cleaned in Microsoft Excel 2007 and examined using SPSS version 16.0. Only 13% of the 62 medical facilities were found to store medications according to the specified parameters, with humidity and temperature levels beyond those limits. 37 batches out of 244 batches including 20 distinct generic versions of necessary medications were discovered to be subpar. Ciprofloxacin hydrochloride eye/ear drop, iron supplement pills, Metformin hydrochloric tablet, Metronidazole tablets, oral suspension of paracetamol, paracetamol tablet, and Povidone iodine solution were among these subpar medications. The report urges the Nepali government to make assuring the nation's supply of vital medications a top priority.