Background and Objectives: Adverse Drug Events (ADEs) are a global problem for healthcare professionals. This study aimed to investigate the fate and actions that have been taken by various healthcare providers after each incident of an ADE, including medication errors (ME) or adverse drug reactions (ADR) in tertiary academic hospitals in Saudi Arabia. Methods: A retrospective cross-sectional study was conducted between January and September 2017. A total of 5453 events were checked manually to determine the action taken. Results: Out of 5453 ADE reports among the included patients, only 34 reports (0.62%) were ADR, while most of the reports were related to medication errors (99.38%). Internal medicine, general surgery, and general pediatrics (20%, 15%, and 13%, respectively) were the most errors reporting specialties. Regarding Fate, 1631 (30%) of MEs (medication errors) were omission followed by 1627 (30.8%) by adjusting the dose, 850 (15.7%) had medication restrictions, 630 (11.6%) medication discontinuation and 240 (4.4%) had no action. Conclusions: Most of the ADEs were related to MEs. However wrong dose, unauthorized prescription, and wrong patient were the most common conditions attributed to MEs. Informed physician, adjustments, and medication discontinuation were the most actions taken to control ME, while ADRs were by rescue therapy as an immediate action. Awareness about ADRs reporting is needed among healthcare professionals in the current settings to ensure an effective ADRs reporting process.