Introduction: The quality of a healthcare service relies on the rational use and the tight regulation of evidence-based medicine. By understanding how consumers take their medicines, policy makers were able to make appropriate intervention that caters for the practices and beliefs of the community. This cross-sectional survey study aimed to investigate the knowledge, awareness and behaviour of medicines usage by consumers in Sarawak. Method: A self-administered, paper-based validated questionnaire was distributed to the general public from 1st September to 31st October 2013. A proportionate cluster sampling was conducted, followed by stratified sampling to ensure similar sample size between urban and rural areas. Chi-square test was used to identify any statistically significant differences between urban and rural participants with their preference. Results and Discussion: A total of 442 respondents were recruited where more respondents from rural area (253, 57.2%) were recruited. More than half of the respondents from both urban and rural groups respectively took some forms of medicines (urban: 111, 58.7%; rural: 156; 65.6%), mostly on health supplements (urban: 48, 25.4%; rural: 61, 24.1%). In terms of the place to obtain their medicines, the Sarawak consumers preferred local government hospital or clinic with 128 (67.7%) among urban group and 221 (87.4%) among rural groups. Only half of the respondents in urban group (50.3%) were aware of “Know Your Medicine” campaign and 63.6% in rural group (p<0.05). Conclusion: The knowledge of respondents towards the correct use of medicines was still considered unsatisfactory.