Sore throat is a common health problem. The underlying cause is often acute pharyngitis. Substantial etiologies are viruses and Streptococcus pyogenes(group A beta-hemolytic streptococci). Differentiation of the cause of pharyngitis is extremely important owing to the need for appropriate drug treatment. Accordingly, this review article incorporates details of sore throat caused by acute pharyngitis, especially infection by S. pyogenes, and strategies for pharyngitis diagnosis in community pharmacies using clinical manifestations and clinical scoring systems. These could improve diagnostic accuracy and also reduce antibiotic overuse and drug resistance.