The lack of approved age-appropriate formulations in health systems undermines treatment efficacy in Paediatric populations and increases the risk of adverse drug reactions. This study assessed the availability of age-appropriate formulations for children in three selected hospitals in Kabul: the Indira Gandhi Institute of Child Health, Ataturk Hospital, and FMIC. A comprehensive review of hospital formularies was conducted to evaluate medications based on their approval status across Paediatric subgroups using drug labelling information in the UK and USA. Additionally, the suitability of oral formulations was assessed following WHO recommendations, including oral liquids, chewable tablets, rapidly disintegrating tablets, and granules. Semi-structured interviews with hospital pharmacists explored how the lack of Paediatric formulations is managed. Findings revealed that unlicensed medications were most prevalent in neonates (61.9%), with a marked decline in adolescents (17.8%). For children under six years, 40.1% of medications had suitable Paediatric formulations, while only 26.8% were both suitable and licensed. Respiratory and antibiotic medications had the highest availability of suitable and licensed formulations, whereas cardiovascular and haematological medicines had the lowest. Notably, FMIC was the only hospital providing compounded medication services for both inpatients and outpatients.