Background: Transparency in research is crucial as it allows for the scrutiny and replication of findings, fosters confidence in scientific outcomes, and ultimately contributes to the advancement of knowledge and the betterment of society. Aim: We aimed to assess adherence to five practices promoting transparency in scientific publications (data availability, code availability, protocol registration, conflicts of interest (COI) and funding disclosures) from open-access articles published in medical journals. Methods: We searched and exported all open-access articles from Science Citation Index Expanded (SCIE)-indexed journals through the Europe PubMed Central database published until March 16, 2024. Basic journal- and article-related information was retrieved from the database. We used R to produce descriptive statistics. Results: The analysis included 2,189,542 open-access articles from SCIE-indexed medical journals. Of these, 87.5% (95% CI: 87.4%-87.5%) disclosed COI and 80.1% (95% CI: 80.0%-80.1%) disclosed funding. Protocol registration was present in 6.6% (95% CI: 6.6%-6.6%), data sharing in 7.6% (95% CI: 7.6%-7.6%), and code sharing in 1.4% (95% CI: 1.4%-1.4%) of the articles. More than 76.0% adhered to at least two transparency practices, while full adherence to all five practices was less than 0.02%. The data showed an increasing trend in adherence to transparency practices since the late 2000s. COI and funding were disclosed more often in lower impact factor journals whereas protocol registration and data and code sharing were more prevalent in higher impact factor journals (all had P-values<0.001). Also, articles that did not disclose their COI had higher median citations. Among all fields, Rheumatology (97.2%), Neuroimaging (94.6%), Anesthesiology (32.4%), Genetics & Heredity (36.7%), and Neuroimaging (12.5%) showed the highest level of transparency in COI and funding disclosure, protocol registration, and data and code sharing, respectively. Whereas Medicine, Legal (61.5%), Andrology (59.0%), Materials Science, Biomaterials (0.3%), Surgery (1.5%), and Nursing (<0.01%) showed the lowest adherence. Conclusion: While most articles and fields had a COI disclosure, adherence to other transparent practices was far from acceptable. To increase protocol registration, data, and code sharing, much stronger commitment is needed from all stakeholders.