The fixed dose combination (FDC) therapy varies among countries. The available combination drugs in the market include both rational and irrational ones. The use of irrational fixed dose combination has a great impact on consumers, society and the nation. Since a few studies on prescribing patterns of fixed dose combination are available in literature, there is need for such a study. In this prospective study, carried out in a tertiary care teaching private hospital, one thousand prescriptions from the hospital pharmacy were collected, classified according to anatomic therapeutic and chemical (ATC) classification. The fixed drug combination used was compared with the essential drug list of World Health Organization (WHO) and other countries. In one thousand prescriptions, 3151 drugs were prescribed, of which, 960 were fixed dose combination drugs. Among those, the anti-infective agents for systemic use (17.5%) and drugs affecting the central nervous system (17.08%), cardiovascular system (15.41%) and alimentary system (11.14%) mainly contributed to the fixed dose combinations. The highest percentage of FDCs was seen among the nervous system (36.6%), anti-infective (33.67), anti-neoplastic (31%), respiratory system (31%) and various drugs (35.90%) category which were more than the average percentage of fixed dose combination drug use (30.47%). Majority of the FDCs prescribed (73.25%) were not approved in the WHO essential drug list. There is a significant burden of these combinations on consumers, physicians and policy makers which needs to be handled with care.