Freddy Pharkas was one of the fastest guns in the American West of the 1880's. However in one particular gunfight with an outlaw named Kenny he was outgunned and Freddy had his ear shot off. This traumatic experience caused Freddy to give up his pistols and enroll in the school of pharmacology. Blocking out the memories of his past, Freddy arrives in the town of Coarsegold with the dream to own and run his own pharmacy. Working with the town's doctor, Freddy is able to fill prescriptions, mix concoctions and diagnose simple symptoms. Business among the townsfolk is brisk however, the good times are not to last as suddenly townsfolk are run out of town and businesses are being foreclosed and boarded up. Freddy must deal with the town's problems, and discover the larger plot, or risk having a fancy shop in an empty town and losing all his customers.

Freddy Pharkas: Frontier Pharmacist is a humorous point-and-click adventure game bearing many similarities to other Sierra titles in the same genre, in particular Leisure Suit Larry series. Players use the command bar at the top of the screen to choose a verb command that is combined with locations and objects visible to the player. Freddy can walk to new locations, look at particular objects, attempt to use objects, talk to people and enter his inventory to access items that have been picked up. Like other Sierra games, successful actions add to the player's score, judging the player on 1000 points.