Cancer remains a significant global health challenge, with India adding approximately one million new cases annually. The rising prevalence necessitates effective management strategies, including the appropriate utilization of chemotherapeutic agents. Aim: This study aims to evaluate the drug utilization patterns and perform a cost analysis of prescriptions in cancer patients at a tertiary care teaching hospital in Jaipur, India. Methodology: A cross-sectional study was conducted over 18 months, involving 237 cancer patients admitted to the medical oncology department. The study assessed demographic details, clinical characteristics, drug utilization patterns, and cost analysis of prescriptions. WHO drug prescribing indicators were used to evaluate the rationality of prescriptions. Data were analyzed using descriptive statistics. Results: The study included 237 patients with a mean age of 53.62 years. The majority were male (62%), and the most common age group was 51-60 years. Gastrointestinal cancers were the most prevalent, followed by respiratory and female reproductive cancers. Platinum coordination complexes were the most frequently prescribed drugs (29.7%), followed by Taxanes (15.4%) and Anti-metabolites (12.8%). The average number of drugs per prescription was 7.89, with 82% prescribed by generic names. Injections were used in 98% of cases, and 62% of prescriptions included drugs from the National Essential Medicine List. The mean cost of chemotherapy per prescription was Rs 36,255, with targeted therapies being the most expensive. Conclusion: The study highlights importance of monitoring the drug utilisation studies regularly which will help in updating the treatment protocols with new therapies coming, provide rational and, cost effective management of the cancer patients. This will further reduce irrational use of anti-cancer drugs.