Patient safety is a fundamental principle of health care. The process of delivering care to the patients contains a certain degree of inherently unsafe. Approximately 1 in 10 hospital patients’ experiences an adverse event, of which half may be attributed to clinical error and a third result in significant harm or death. Clinical errors in emergency medicine may include errors of patient identification, hospital-acquired infections due to poor procedure asepsis, patient isolation procedures, medication errors, misdiagnosis, and failure of follow-up of investigation, communication errors, physical care and miss-triage. Improving patient safety in emergency department requires an understanding of the emergency department environment and a methodical stepwise approach of improving safety based upon factoring reporting of clinical incidents and evaluating reported incidents using accepted methodologies such as root cause analysis. Patient safety should be monitored proactively in order to ascertain risks and assist assessment and refinement of interventions to improve patient safety.