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The design of medicinal information in leaflets and labels is often criticized for not meeting patients' needs. For that reason, there is an increasing focus on how the use of pictures, such as pictograms, may benefit patients on their medical journey. However, before a pictogram can be comprehended it must be legible, which may be a challenge when pharmaceutical information has to be conveyed. Within a limited space many visual details need to be included in order to clarify the intended meaning. While we have abundant information about the comprehension of pictograms, we know very little about the legibility - the ability to visually identify objects - of pictograms. By looking at legibility research into pharmaceutical pictograms from a design perspective, this paper demonstrates that legibility is not prioritized either in theory or in practice. In order to proceed with the use and implementation of pictograms in, for example, patient information leaflets and labels, we need to know more about the features that constitute legibility. To create a research foundation, this paper draws on knowledge of visibility and legibility from related domains. This forms the basis of a discussion of the need for future research to focus on legibility issues, amongst others by incorporating design knowledge into experiments.