OBJECTIVES:  Medication errors (ME) frequently contribute for patient’s morbidity and mortality in health care settings. The present study was aimed to identify and assess the pattern of occurrence of MEs and to develop strategies to prevent these MEs. METHODS:  It was a prospective study conducted in a teaching hospital over a period of 6 months. Trainee clinical pharmacists followed the patients admitted to general medicine (GM) and general surgery (GS) wards. MEs occurred and the cause for ME was identified by reviewing medical records, interviewing patients and concerned health care professionals (HCPs). Identified MEs were evaluated for its nature, extent, cause and outcome. Strategies for prevention of MEs were developed. RESULTS:  Of the 3035 patients followed, 988 MEs were identified in 703 patients. Prescribing errors were observed highest, both in GM (71.45%) and GS wards (60.4%). The most common reasons for MEs were omission errors (25%), monitoring errors (18.52%), non-adherence to medication (15%), inappropriate drug selection (14%) and drug duplication (12.6%). Most of the MEs were due to inappropriate prescribing by clinicians (51%) followed by patient non-adherence to therapy (21%), improper follow up by ward clinical pharmacists (17%) and administration errors by nursing staff (11%). Strategies were designed to prevent commonly identified MEs. Majority of MEs that reached to patients were not harmful but 48% of them needed monitoring/intervention to ensure patient safety. CONCLUSIONS: Most of the MEs can be prevented if patients are monitored correctly. Appropriate team work from all HCPs can certainly reduce the occurrence of MEs. Implementation of Medication error reporting system in the hospital on larger scale can improve the quality and safe use of medicines.