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Background Prescribing errors are common in hospital settings and can lead to severe harm to patients. Pharmacist-conducted medication order verification where a pharmacist ensures order appropriateness has been recommended to ensure safe prescribing in hospitals, but systematic scientific evidence of the efficiency is lacking. The objective of this study was to study the effects of pharmacist-conducted medication order verification in hospital settings.Methods This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 criteria and was registered in PROSPERO. The final literature search was conducted in February 2024 covering the period 2000–2023. Only peer-reviewed studies considering the effects of pharmacist-conducted medication order verification in hospital settings were included. Study selection, data extraction and quality assessment were carried out by two individual reviewers. The findings describing the effects of pharmacist-conducted medication order verification were synthesised and categorised according to the Economic, Clinical, and Humanistic Outcomes (ECHO) model.Results A total of 35 studies met the inclusion criteria. All of the studies (n=34) reporting clinical outcomes showed positive results. Pharmacist-conducted medication order verification could detect a wide variability in drug-related problems, with dose-related issues being the most common (n=33 studies). The physician acceptance rate in the pharmacist intervention studies (n=27) varied from 26% up to 100%. Of the verifications, 0.8–45.2% led to a pharmacist intervention. Economic outcomes were reported in seven studies and all showed positive results. None of the included studies reported humanistic outcomes.Conclusions Pharmacist-conducted medication order verification is associated with prevention of drug-related problems and cost savings in hospital settings. Further research is needed on the quality of pharmacist-conducted medication order verification, high-quality studies investigating the economic benefits, the effects on the patient perspective and outpatient medication prescriptions.