Introduction: The pharmacy profession has a growing opportunity to provide high-quality patient care to urban underserved patients. The Accreditation Council for Pharmacy Education (ACPE) has also recognized the necessity of training pharmacy students to care for underserved patients within Standard 3.5 in Standards 2016. Despite this recognized need to train students to care for urban underserved patients, there is limited literature to guide schools and colleges of pharmacy in developing learning activities and curricula to meet this need. Methods: This study utilized a three-round modified Delphi process to develop learning competencies. Participation was solicited from pharmacy practice faculty members of the American Association of Colleges of Pharmacy (AACP) Health Disparities and Cultural Competency Special Interest Group (SIG). This study used a proportion of experts rating agree or strongly agree at 80% to determine consensus. Results: The expert pool had a combined 235 years of pharmacy practice experience in urban underserved settings. Ten learning competencies were developed and finalized: Identified learning competencies related to the development of pharmaceutical and social knowledge base; development of pharmaceutical care and social skills; and building awareness of benefits and disadvantages of working with urban underserved patient populations. Discussion: The learning competencies described in this study provide schools and colleges of pharmacy a tool to help guide learning activity and curricular development to educate students to provide high-quality and compassionate care to urban underserved patients. Conclusions: This study is the first description of practice-based student learning competencies for urban underserved pharmacy practice in the literature.