OBJECTIVES: Medication errors may occur during the drug picking process whereby the wrong drug, strength or quantity is picked. In May 2012, LED were installed and tagged to drug bins at the outpatient pharmacy in Singapore General Hospital with the intent to prevent these costly errors. Upon scanning a Quick Response (QR) code on the drug label, the LED corresponding to the drug bin will light up, signaling the picker to the correct drug bin. This study seeks to evaluate the safety impact of LED-guided drug picking and pharmacy staff's acceptance of this system. METHODS: The primary outcome of this study is the safety of the drug picking process measured in terms of the frequency of picking near misses. Near miss data before (January to April 2012) and after (May to August 2012) implementation of LED-guided drug picking were extracted electronically for statistical comparison. A survey was administered on pharmacy staff (n = 50) to find out their acceptance on drug picking with and without LED-guidance. Data from the survey were collated and analyzed descriptively. RESULTS: The implementation of LED-guided drug picking significantly reduced near misses for wrong drug [7.18 ± 3.17 vs 2.71 ± 1.36, p<0.001] and wrong strength [3.47 ± 2.48 vs 1.82 ± 1.13, p=0.02]. There was no significant difference in the frequency of picking near misses for wrong quantity [17.8 ± 9.88 vs 14.0 ± 4.64, p=0.162]. Overall, there was a significant reduction in the frequency of total picking near misses [28.4 ± 13.2 vs 18.1 ± 5.44, p=0.007]. Pharmacy staff’s acceptance towards LED-guided picking was generally positive with majority preferring the LED over no LED-guided drug picking. CONCLUSIONS: Incorporation of LED into drug picking significantly decreased near misses of wrong drug and strength that potentially prevented costly medication errors. Pharmacy staff were generally receptive to LED-guided picking.