Objectives To describe and compare the pharmaceutical services and clinical pharmacy roles performed in neonatal intensive care units (NICUs) in Australian versus Polish hospitals. Methods A 26-item survey was distributed electronically to directors of pharmacy as well as neonatal pharmacists in hospitals in Poland and Australia. Most questions were fixed agree/disagree' answers, supplemented by open-ended questions. The survey was distributed between January and May 2017. Results Overall, 30 Australian pharmacists and 22 Polish pharmacists completed the survey. Significant differences were observed in the types of pharmaceutical care services provided to NICUs between Australia and Poland. A higher proportion of Australians than Poles performed clinical roles: for example, providing medication recommendations (Aus=96.6%, Pol=9.1%, P<0.001); pharmaceutical interventions to resolve drug therapy problems (Aus=93.1%, Pol=18.2%, P<0.001); and general patient medication chart review (Aus=96.6%, Pol=13.6%, P<0.001). All (100%) Polish pharmacists did not consider themselves members of the NICU team and the majority (59.1%) felt that pharmaceutical care on the NICU was practically non-existent. Conclusion Future research should focus on bringing practice in countries such as Poland closer in line with practice in countries such as Australia.