Specialist pharmacists have become an established feature of the antibiotic stewardship landscape in hospitals throughout the UK over the last decade. This review examines the origins of the specialist antibiotic pharmacist and how the role has developed in recent years. Antibiotic pharmacists fulfil a vital function in modern National Health Service hospitals as key members of the infection control team with overall responsibility for initiatives to promote rational antibiotic prescribing. Evidence of the impact of antibiotic pharmacists on clinical, microbiological and financial outcomes is presented along with examples of innovative practice. Finally, a vision for the future of the antibiotic pharmacist role is outlined.