Aim: To analyze the availability of medicinal products for the Ukrainian population under martial law, identify key challenges in the pharmaceutical sector, and substantiate adaptive approaches for ensuring continuous pharmaceutical provision. Materials and Methods: A systematic analysis of regulatory, legal, and empirical data (2022–2025) was conducted using sources from the Ministry of Health of Ukraine, the Ministry of Digital Transformation of Ukraine, the State Service of Ukraine on Medicines and Drugs Control, and international organizations. The search covered the period from February 2022 to early 2026, corresponding to the duration of full-scale war and martial law in Ukraine. Sources were included if they addressed pharmaceutical provision, access to medicines, or pharmacy services; reflected the functioning of healthcare or pharmaceutical systems under crisis or wartime conditions; provided empirical data, regulatory information, or analytical insights; and were published in peer-reviewed journals, official reports, or credible professional and industry platforms in English or Ukrainian. Sources were excluded if they were not relevant to pharmaceutical accessibility or healthcare delivery, lacked analytical or factual content, duplicated previously identified sources, or originated from unverified platforms. The initial search and screening resulted in 68 sources. After preliminary screening and relevance assessment, 32 sources were selected for full-text review. Ultimately, 21 sources were included in the final analysis, forming the evidence base of this study. Conclusions: The pharmaceutical sector in Ukraine demonstrated high adaptive capacity under martial law. Despite infrastructural damage, workforce shortages, disrupted supply chains, and reduced affordability, the implementation of adaptive mechanisms improved access to essential medicines. Alternative delivery models (mobile pharmacies and “Ukrposhta. Pharmacy”), digital monitoring tools, regulatory simplification, and financial support programs enhanced both physical and economic accessibility. The integrated approach combining regulatory flexibility, digitalization, and alternative distribution systems ensures continuity of pharmaceutical provision and strengthens long-term resilience under crisis conditions.