BACKGROUNDMedication administration is one of the critical competencies in nursing to ensure patient safety. Globally, a lack of competence in medication administration has been associated with high morbidity and mortality rates and poor patient outcomes. This study focused on assessing knowledge of medication administration among undergraduate nursing students.MATERIALS AND METHODSThis descriptive cross-sectional study was conducted between June and August 2021 in two County Referral Hospitals in Kenya. The study aimed to establish the level of knowledge on medication administration among second-year nursing students starting their clinical rotations, mainly in the medical/surgical wards. The census method was used to recruit 147 participants based on the pre-defined inclusion criteria. The data was collected using a pretested interviewer-administered knowledge questionnaire based on the World Health Organization (WHO) training curriculum on medication safety. The data was then cleaned, coded and analysed using SPSS version 26. Descriptive and inferential statistics were used to summarise and compare the results.RESULTSThe average score for the medication administration knowledge was 64.8 %, S.D=5.8. The highest score was 79%, whereas the lowest was 43 %. Poor performance was noted in five of the six categories of medication administration, whereby the total number of participants who passed the knowledge assessment with a score of 70% and above was 43 (29.3%) per the international recommendations. The proportion of those who passed differed significantly from those who failed the knowledge assessment, χ2 (1, n=147) =25.31, p<0.05. The results of one sample chi-square test indicated that most students failed the knowledge assessment in the various categories (p<0.05).CONCLUSION AND RECOMMENDATIONSThe pass mark for high-risk skills such as medication administration is 70%. Therefore, the participants’ knowledge was below the recommended pass mark. Nurse educators must identify the gaps in teaching and consider including the WHO medication safety curriculum guidelines and teaching strategies in the existing institutional undergraduate nursing curriculums to enhance the medication administration process and patient safety.