Objective: To explore the national survey of hospital medication safety practice during mass gathering (Hajj -2016) The survey distributed to sixteen hospitals, the response rate, was eleven hospitals (68.75%). The total score of all ISMP-self assessment of medication safety was 3.39 +/-0.51 (67.68 %) with CI (3.2-3.6) P< 0.05. Medication preparation and dispensing included two domains; communication of drug order with scores 3.53 (55%), drug labeling and packaging with scores 3.57 (71.4%). The highest score of two sections the products with look-alike drug names and packaging segregated and not stored alphabetically 4.5 (90%) while the lowest score was a presenting of alerting with computerized physician order entry 2.1 (42%). Conclusion:The standardized medication process during preparation and dispensing is acceptable rate with missing the intravenous admixture and repackaging services. Targeting to continue the level of improvement and correction the missing services is the potential goals in the mass gathering pharmaceutical care during Hajj period. In addition to the annual survey of medication safety during medication preparation and dispensing is a crucial requirement of best medical services provided to all pilgrims in Makkah, Saudi Arabia.