Hospitals with American Society of Hospital Pharmacists accredited residencies were surveyed to assess the state of the art for adverse drug reaction (ADR) reporting. A majority of hospitals used a concurrent ADR reporting mechanism. Only one-fourth of hospitals assessed the causal relationship between the drug and the ADR, whereas the majority assessed the severity of the ADR. Fifty-eight per cent of hospitals received fewer than seven ADR reports in a 6-month period. Antiinfective agents and central nervous system drugs were most frequently cited as causing ADRs. Various corrective action has been taken to reduce ADRs, including changing drug administration procedures, promoting awareness of ADRs, patient teaching, and drug monitoring.