OBJECTIVE：To prov ide reference for continuously improving the management of high-risk drugs in hospitals. METHODS：Taking the First Affiliated Hospital of Xinjiang Medical University （called“our hospital ”for short ）as an example ， based on the Joint Commission Intemational （JCI）certification standard ，in order to solve the problems in the management of clinical high-risk drugs in our hospital ，high-risk drug management system was established. The specific measures included the establishment of a multi-intelligent system drug management system ，the establishment of hospital pharmaceutical administration and drug treatment committee ，the development of high-risk drug list and the hospital ’s unified high-risk drug logo ，the improvement of high-risk drug storage scheme ，the standardization of physician ’s behavior of issuing medical orders ，the standardization of high-risk drug review ，dispensing，preparation and distribution ，the standardization of high-risk drug delivery. A series of standardized tests were carried out for high risk drugs ，and continuous measure optimization was taken according to the effect. The pharmacist ’s awareness rate （full score was 10. The higher the score was ，the higher the cognitive level was ），nurse’s management compliance rate and pharmacist ’s prescription error rate of high-risk drugs were compared between before optimization （2016-2017）and after optimization （2018-2019）. RESULTS ：After the optimization of high-risk drug system in our hospital ，the pharmacist’s awareness rate of high-risk drugs increased significantly（including drug list ，indication，contraindications， dispensing and review ）；the scores of the above five aspects E-mail：357006530@qq.com were increased from （9.32±0.32），（9.10±0.32），（9.21±0.46），（9.24±0.40），（9.35±0.45）scores before optimization 4362634。 to（9.90±0.10），（9.90±0.14），（9.90±0.10），（9.90± 0.10），（9.85±0.15）scores after optimization ；prescription error rate of high-risk drugs dealed by pharmacists decreased from 10.31％（33/320）to 1.25％（1/80）；the nurse ’s management compliance rate of high-risk drugs increased from 95.25％ to 99.63％，with statistical significance （P＜0.05）. CONCLUSIONS ：The establishment and continuous optimization of high-risk drug management system and process can reduce the proportion of high-risk drug errors in error prescriptions and promote the safety management of high-risk drugs.