The present invention relates to an automatic pill counting and packaging apparatus which may automatically count and package pills into a pouch having a sealable inlet. The automatic pill counting and packaging apparatus includes a bottom transfer part for supplying a pouch, a top transfer part disposed at an upper portion of the bottom transfer part for supplying pills, a counting part for counting the pills supplied by the top transfer part, and a packing part for inputting and packing the pills supplied by the top transfer part into the pouch supplied by the bottom transfer part.