Pharmacovigilance is an essential component of patient safety, focusing on the detection, assessment, understanding, and prevention of adverse drug reactions (ADRs) and other drug-related problems. Clinical pharmacists play a pivotal role in pharmacovigilance due to their expertise in pharmacotherapy and direct interaction with patients and healthcare teams. They are involved in identifying and reporting ADRs, assessing causality, preventing medication errors, and providing patient counselling to ensure safe medication use. Despite challenges such as underreporting, lack of awareness, and limited resources, the active participation of clinical pharmacists strengthens pharmacovigilance practices in hospitals. This narrative review highlights the roles and responsibilities of clinical pharmacists in pharmacovigilance, the importance of their involvement in hospital settings, challenges faced in practice, and future perspectives to enhance patient safety. Strengthening the contribution of clinical pharmacists in pharmacovigilance can improve therapeutic outcomes, reduce drug-related harm, and promote a culture of medication safety in healthcare systems.