Background: In Nepal, while the use of the emergency contraceptive pill (ECP) has been increasing rapidly in recent years, very little is known about the profile of ECP users. This study assesses the increasing role of ECP and the profile of ECP users in Nepal. Some policy and programmatic concerns are also addressed. Methods: Survey interviews were undertaken involving 185 women who visited five metropolitan medical shops located in Pokhara seeking to purchase ECP for their own use. Descriptive statistics were calculated for data analysis. Results: ECP is popular among young (<25 years old) and educated women. Also, nearly 70 % of the ECP users described their most recent sexual relationship as infrequent/casual. The overwhelming majority of users are aware that ECP is for emergency use only. Most ECP users are also aware of other options like condoms, the oral pill, and injectable contraceptives; and a considerable proportion of women using ECP had also used these methods before. Conclusion: ECP is filling an important and unique role in reducing unplanned or unwanted pregnancy, especially among young, educated women, and those with infrequent sexual relationships.