Objective: To compare client profiles and activity data from the pharmacy needle exchanges (PNEXs) with other needle exchanges (NEXs) in a UK city. Method: Routinely collected data from four types of needle exchange services were used to analyse levels of activity and user profiles. Simple descriptive statistics with 95% confidence intervals (95% CI) were calculated. Setting: In Glasgow, Scotland, at the time of the study NEX was provided at four key facilities: (1) PNEXs; (2) drug treatment service sites (Glasgow Drug Problem Service, GDPS); (3) a drop-in service for female prostitutes (Base 75); and (4) a service based in a 24-hour crisis assessment and treatment centre (Glasgow Drug Crisis Centre, GDCC). Key findings: A total of 1 074 455 needles/syringes were issued during the study period. Over half of all needles and syringes were issued from PNEXs (52%; 558176) compared with 15% (162 431) from GDPS, 5% (59 348) from the Base 75 exchange and 27% (294 500) from the GDCC. The return rate at PNEXs was 86% (95% confidence interval (CI) 85.90-86.10%) and was significantly higher than both GDCC (70%, 95% CI 69.80-70.19%) and Base 75 (25%, 95% CI 24.31-25.69%). A significantly greater proportion of needles and syringes were returned to the GDPS (94%, 95% CI 93.88-94.12%) than to PNEXs (86%). A significantly greater proportion of female clients attended GDCC (30%, 95% CI 27.41-32.59%) than the PNEXs (25%, 95% CI 23.80-26.20%). Conclusion: PNEXs attract large numbers of injectors to use the service and have a high return rate of needles and syringes issued. A diverse population uses PNEXs. In order to meet the needs of different groups of injecting drug users, a variety of NEX facilities is needed, including out of hours services and exchanges for women, especially those in crisis or involved in prostitution.