The extant literature lacks a systematic investigation of the specific roles undertaken within pharmaceutical counterfeiting schemes. We attempt to address this knowledge gap through an analysis of individuals convicted in federal court of counterfeiting offenses related to U.S.-based pharmaceutical counterfeiting incidents. From our investigation we identified six distinct roles that can classify an individual’s involvement in a pharmaceutical counterfeiting scheme: Key/Lead, Supporting, Sales/Distribution to Legitimate Others, Sales/Distribution to Illegitimate Others, Production, and Purchase. Through an examination of these roles and their distinct characteristics we propose several role-related crime prevention strategies.