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Background and Importance Parenteral nutrition (PN) solutions are critical for patients who are unable to receive adequate nutrition orally. Manual compounding of PN solutions is prone to human error, which can lead to severe clinical consequences. Automated compounding systems (ACS) have been introduced as a potential solution to enhance accuracy and safety in PN preparation.Aim and Objectives This study aimed to compare the accuracy, safety, and efficiency of manual versus automated compounding of PN solutions in a hospital pharmacy settingMaterial and Methods A retrospective study was conducted at a tertiary care hospital, comparing 500 manually prepared PN solutions with 500 prepared using an ACS. Data on compounding errors, preparation time, and staff satisfaction were collected. Errors were classified as major or minor, and preparation time was measured in minutes. Statistical analysis involved Chi-squared tests for error rates and paired t-tests for preparation times.Results The ACS group demonstrated a 70% reduction in major errors (p = 0.01) and a 50% reduction in minor errors (p = 0.02) compared to the manual group. Preparation time was 30% shorter in the ACS group (p = 0.03), and staff satisfaction increased by 40% (p = 0.04).Conclusion and Relevance Automated compounding of PN solutions significantly reduces errors and preparation time while improving staff satisfaction. These findings suggest that ACS should be integrated into hospital pharmacy practice for PN preparation to improve patient safety and operational efficiency.References and/or Acknowledgements 1. Perrier Q, Hosni A, Leenhardt J, Desruet MD, Durand M, Bedouch P. Automation of parenteral nutrition: impact on process and cost analysis. Eur J Hosp Pharm. 2024 Aug 22;31(5):468–473. doi: 10.1136/ejhpharm-2022-003602. PMID: 37068926.Conflict of Interest No conflict of interest