We carried out a cross-sectional, web-based study to identify predictors (personal characteristics, knowledge, and attitudes) of Serbian pharmacists' decisions to decline emergency contraceptive pills (ECP) dispensing. In total, 452 questionnaires were completed and analyzed. Half of the surveyed pharmacists had poor knowledge of ECP. Almost the same number (42%) had either never undertaken training in these products or did not remember having training. The less knowledgeable respondents were more likely to decline ECP provision overall (OR 1.862) and in particular circumstances (nonintended user (OR 1.412) or >72 h after intercourse (OR 1.445)). To expand availability of these products, well-organized trainings are needed.