This report documents findings from a study of the status of medicines regulation capacities, harmonization efforts and challenges in ECOWAS and member states. Data collected from 13 out of 15 NMRAs and two pharmaceutical industries from ECOWAS is presented. The data reveals important challenges experienced by ECOWAS in driving the harmonization of medicines regulation.  The report concludes with recommendations pertaining to the legal framework, registration of medicines, sharing of information and capacity building as areas to be improved upon in addressing the challenges associated with medicines registration harmonization for ECOWAS.