Adverse drug reaction (ADR) reporting is crucial for patient safety and the continuous monitoring of medication risks. This study examines the factors influencing ADR reporting and system effectiveness in Saudi Arabia and provides implications and recommendations to enhance the pharmacovigilance system. The findings highlight the importance of healthcare professional education and training to improve ADR reporting rates. Establishing a positive reporting culture and strengthening communication among stakeholders are essential for encouraging reporting and improving system effectiveness. Regulatory support, including user-friendly reporting systems and timely feedback, is necessary to facilitate reporting. Promoting patient involvement and empowerment, along with technological integration, can further enhance the ADR reporting process. International collaboration and continuous evaluation are crucial for identifying global safety concerns and implementing improvements. Implementing the recommendations can strengthen the ADR reporting system, optimize patient safety, and contribute to the continuous improvement of pharmacovigilance. Collaboration among regulatory authorities, healthcare organizations, and other stakeholders is essential for achieving a comprehensive and effective approach to ADR reporting and ensuring safe and effective healthcare practices.