Retail internationalisation has been studied from multiple points of views, however the differences in internationalisation processes and how internal and external elements influence the process has not been adequately understood. This paper describes a highly regulated sector, pharmaceutical retail, as a possible context to further study the influence of institutional elements. The findings of this study suggest that within a highly regulated sector the institutional elements and their influence are highlighted and more visible than in other sectors. Thus, further studies could explore the influence of the institutional environment on the decision making processes and international evolution of pharmaceutical retail chains, and on the other hand their influence on the changes of the institutional environment.