Objective: The present study was designed to assess the perception, need and the barriers of PV and ADRs reporting in the hospital settings of Karachi, Pakistan. Methods: A cross-sectional survey was conducted from October 2019 to February 2020 by the random sampling in the healthcare professionals including physicians, pharmacists and nurses. Questionnaire was distributed to 525 participants (n=175 from each group) being serving for one or more year in hospitals and clinics. Overall, 425 participants were responded having 138 physicians, 143 pharmacists and 145 nurses. Results: Perception of pharmacovigilance was found to be 81.02%, 73.40% and 35.17% respectively in physicians, pharmacists and nurses. Overall, 80.70% of respondents were felt the need of drug monitoring system in each hospital to improve patients’ responses against treatment. The main hindrance for PV in our society was the lacking/ absence of the ADRs monitoring and reporting system marked by the physicians and pharmacists. Conclusion: ADRs reporting and pharmacovigilance are not practiced properly in our region. It’s a time to pay attention to this neglected area not only to strengthen the infra structure of healthcare units but also to increase the patient compliance and to avoid any drug associated disaster in future.