Objective: To describe older African Americans’ communication with pharmacists and their opinions, beliefs, perceptions, and attitudes about the role of the community pharmacist. Design: We conducted six sex-specific focus groups for this qualitative study. Setting: Community-based senior-serving agency located in a predominantly African American neighborhood in San Francisco, California. Participants: Insured, older African Americans (.60 years of age) with chronic disease; 30 women (4 groups) and 12 men (2 groups). Results: A majority of participants took four to six prescription medications and reported an average of two chronic illnesses. While most expressed a desire to have a trusting relationship with a community pharmacist who is respectful, professional, and knowledgeable, none reported such a relationship, stating that the primary function associated with pharmacists is filling prescriptions. Participants reported an interest in engaging in informed decision-making, including discussions regarding medication options, side effects, and concerns about rising medication costs; however, few reported feeling comfortable initiating such discussions. Communication barriers identified by participants included perceived lack of interest or knowledge by the pharmacist, time constraints, and an inability to identify the pharmacist. Conclusions: It appears that the role of the pharmacist is not being fully realized by this sample of insured, older African Americans with chronic disease. This may be mediated by suboptimal experiences of patient-pharmacist communication and the patient-pharmacist relationship. Future research is needed to examine the patient-pharmacist relationship and its contribution to health disparities to inform pharmacy practice, training, and policy. (Ethn Dis. 2007;17:284–290)