The current pharmaceutical industry experiences significant problems when attempting to adopt sustainable practices and meet the world’s demand for medicines. This chapter provides an overview and a comprehensive framework of pharmaceutical companies for sustainable development, which is called the seven pillars. They are the following: environmental stewardship, economic viability, social responsibility, quality and safety excellence, innovation and technology, supply chain, and leadership and collaboration. After introducing the sustainability of pharmaceutical development and the reasons for the need for the abovementioned practices, these seven pillars are presented, and their detailed analysis, together with examples, is included. In particular, the first pillar of environmental stewardship is further analyzed from the subpoints of green chemistry and engineering, waste minimization and management, energy efficiency, the use of renewable sources, and the minimization of water usage and wastewater management. The chapter makes several valid points, stating that these practices are necessary to reduce the industry’s environmental impact and expenses and meet society’s ethical and value expectations. In this case, future studies should focus on practical applications, the development of a set of standards, and the increased role of multistakeholder collaboration.