Chemotherapeutic drugs share the characteristic of providing life-saving benefits at the expense of substantial toxicity if not administered and monitored carefully. With ongoing advances in such therapy and a growing shift to outpatient treatment in infusion clinics, this prospective cohort study evaluated more than 10,000 medication orders at a cancer institute in both adult and pediatric settings. Investigators discovered an overall error rate of 3%, with the majority of errors deemed to have a potential for harm. Most of the errors never reached the patient as nurses and pharmacists caught them before administration. Of note, the reported error rate of 3% was lower than past studies in inpatient (5%) and outpatient settings (8%). The authors conclude by sharing the prevention strategies that came from their local findings and how the complexity of outpatient oncology treatment warrants ongoing attention.