The Bangladeshi healthcare system grapples with the entrenched practice of pharmaceutical companies showering medical representatives (MRs) with gifts to influence healthcare professionals (HCPs). Despite legal frameworks like the Drug Act (1940), which, until 2023, served as the core of Bangladesh's pharmaceutical sector regulation framework, was repealed by the Drugs and Cosmetics Act, 2023 and Drug Rules (1946) prohibiting the exchange of gifts and incentives to HCPs, a 2022 survey by Transparency International Bangladesh (TIB) revealed that 77% of physicians acknowledge receiving gifts from pharmaceutical companies. This article explores the reasons behind this phenomenon, including fierce industry competition, manipulation of prescribing habits, and financial allure for HCPs. Further, the article examines the multifaceted impact of gift-giving on patient care, healthcare expenditure, and public trust in the medical profession. It delves into the ethical considerations surrounding conflicts of interest, transparency, and accountability in the pharmaceutical-HCP nexus. Additionally, it analyzes the evolving role of regulatory bodies like the Directorate General of Drug Administration (DGDA) in enforcing regulations governing gift-giving practices. Through a critical examination of recent case studies and relevant literature, this article sheds light on the complex dynamics at play and proposes evidence-based recommendations for fostering transparency, integrity, and ethical conduct within the Bangladeshi pharmaceutical industry and healthcare sector. By drawing comparisons with international regulatory frameworks and ethical standards, the article aims to provide a comprehensive understanding of the challenges and potential solutions to curb unethical practices in Bangladesh.