Aims <p>The primary aim of the study was to identify medication subgroups and individual medications most commonly implicated in drug allergy incidents in Irish acute hospitals. Secondary aims were to determine the severity of drug allergy incidents, stage(s) in the medication use process where drug allergy incidents occur and the profession(s) of staff reporting drug allergy incidents.</p> Methods <p>This retrospective observational study involved a search of the National Incident Management System (NIMS) database for drug allergy incidents reported by acute public hospitals in Ireland from 1st January 2016 to 31st December 2022. The data was analysed under various headings using predetermined fields on NIMS.</p> Results <p>There were 974 drug allergy incidents reported by Irish acute hospitals over the seven-year period. Nursing and midwifery staff reported 65.8% of incidents. Two-thirds (66.2%) of incidents had a severity rating of moderate, signalling that medical treatment was required. Three-quarters (75.8%) of incidents occurred at the administration stage of the medication use process. Penicillins accounted for 16.2% of drug allergy incidents by medication subgroup. Amoxicillin / clavulanic acid and piperacillin / tazobactam together accounted for 82.3% of penicillin allergy incidents. COVID-19 vaccines were the most commonly implicated medication by generic name.</p> Conclusion <p>For the first time in an Irish context, this study provides an in-depth analysis of multi-year national data on drug allergy incidents. The information presented in this study should facilitate hospitals in Ireland in tailoring their drug allergy risk mitigation strategies in order to minimise potential patient harm and avoid future litigation costs.</p>