<p>Influenza remains a major public health challenge, and vaccination is the primary strategy to reduce its burden. Community pharmacies have been introduced as additional vaccination providers in Italy, but their contribution remains insufficiently documented. This study assessed the role of community pharmacies in influenza vaccination in the Siracusa Local Health Authority (LHA) across the 2022/23–2024/25 seasons. A retrospective analysis of the local electronic vaccination registry was conducted. All adults vaccinated during the three influenza seasons were included, with a focus on individuals aged 18–65 years, the group eligible for pharmacy-based vaccination under regional guidelines. Information on vaccine type, administration setting, and patient characteristics was analyzed. Overall, 83,517 individuals received at least one influenza vaccination. Of these, 1,709 (2.0%) were vaccinated in community pharmacies, where standard-dose vaccines predominated (97.1%). Among pharmacy-vaccinated individuals, 272 had at least one underlying condition. In the 18–65-year subgroup, 32,028 individuals were vaccinated, with approximately 2% receiving vaccination in pharmacies. The pharmacy contribution in this subgroup increased over the three seasons from 1.8% to 2.7%. Community pharmacies played a modest but increasing role in influenza vaccination, particularly among adults aged 18–65 years. Within this local setting, the findings reflect an early phase of implementation of pharmacy-based vaccination in Italy. Expanding pharmacy-based vaccination services may improve access to vaccination and support public health strategies to increase adult immunization coverage.</p>