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Among materials usually employed for drug delivery, silica plays a key role, particularly in its mesoporous form. Although much research has been performed on the topic of silica drug delivery, the understanding of the interactions occurring between the material surface and drug molecules is still scarce, despite this knowledge is essential for determining the final performance of a drug-delivery system (DDS). Molecular modeling can give a precious insight on this issue, acting as a virtual microscope to study the processes occurring inside the drug carrier. Ab initio simulations, in particular, can accurately predict geometries and enthalpies of adsorption, infrared and nuclear magnetic resonance spectra, and other experimental observables that can help pharmaceutical researchers to better predict the features of novel DDSs.