Background Medication errors are a leading cause of death globally with the burden on resource-limited countries more than double that in high-income countries. Errors could occur at all stages of the medication use process, however, there is limited information on medication transcription errors (MTEs) within hospitalized patients in Africa. This study sought to determine the prevalence and types of MTEs and to assess nurse’s perceptions of the likely causes of MTEs within the pediatric and general wards at a faith-based hospital in Cameroon Methods This was a prospective chart review of medication orders transcribed for patients admitted from the 1st to the 30th of April 2021. Data analyzed included patient demographics, prevalence of MTEs, types of MTEs, medication classes involved in MTEs, and nurse’s perceptions of the causes of MTEs. Results There were a total of 578 medication orders for 75 patients, 53% (n = 40) were female, and 30 were admitted to the children’s ward. Thirty-eight MTEs were recorded, 47% occurred on the medication administration sheet and medication cards. The most frequent MTEs were omission of new and stop medication orders which were involved in 28.9 and 26% of all MTEs respectively. Antibacterials for systemic use were involved in the majority (55.3%) of MTEs. Illegible prescriptions (90.7%), distractions (87.0%), and higher workload (77.8%) were ascribed as the most likely causes of MTEs. Conclusion MTEs were common and posed a potential risk of patient harm in hospitalized patients. The adoption of a computerized provider order entry system could eliminate illegible prescriptions, transcription, and reduce workload thereby improving patient safety.