 This study examined the effectiveness of antimicrobial stewardship services in treating chronic bone and joint infections among outpatients at a South African tertiary hospital. The results showed that 89% of participants had been diagnosed with chronic osteomyelitis, while 11% had septic arthritis. Of these, 43% were caused by Staphylococcus aureus, and 14% by Pseudomonas aeruginosa. Most patients received antibiotics at baseline, but only 39% of them were prescribed according to the South African Standard Treatment Guideline, STG. Interventions were required and 31% of cases where the STG did not recommend any specific antibiotics. Overall, 77% of patients reported good adherence to their medication regimen. This study suggests that antimicrobial stewardship services can be effective in improving patient outcomes in bone and joint infections.