Objectives: The purpose of this study was to, first, investigate the perceptions of neonatal intensive care unit (NICU) pharmacists and directors of pharmacy in Australia and Poland regarding their level of preparation to perform pharmaceutical care services in the NICU, and second, identify practice barriers and ways to improve services. Method: A cross-sectional, electronic-based survey was distributed among NICU pharmacists and directors of pharmacy working in hospitals with a NICU in Australia and Poland. The survey comprised 12 items, and the majority of questions were fixed binary ‘agree/disagree’ answers, supplemented by open-ended questions. Results: A total of 29 participants from Australia and 20 from Poland completed the survey. Overall, it is apparent that Australian pharmacists felt more competent in clinical and educational roles than Polish participants. For 14 of the 15 clinical roles listed, more than 70% of Australian participants felt that pharmacists had a ‘good’ level of preparation to provide services to the NICU, including performing medication chart reviews (93.1%) and pharmaceutical interventions (96.6%), and collaborating with medical and nursing staff (93.1%). A significantly higher proportion of Polish than Australian pharmacists agreed that changes were needed to improve pharmacist practice in the NICU (90 vs. 53.6%; p = 0.007). Conclusion: Future efforts should focus on developing guidelines and practice standards for sub-specialties of pharmacist practice, such as neonatology, to promote the standardization of practice.