To assess the extent to which cancer centres in Arab countries adhere to the 2016 American Society of Clinical Oncology/Oncology Nursing Society (ASCO/ONS) chemotherapy administration safety standards.

Multicentre cross-sectional survey.

Sample of the largest cancer treatment facilities across 10 Arab countries, including governmental, private, university-affiliated and daycare centres where chemotherapy is administered.

A multidisciplinary team of healthcare professionals (including head nurses, oncologists, oncology pharmacists and quality staff) at each centre completed a structured survey on adherence to the ASCO/ONS chemotherapy administration safety standards.

The primary outcome was the proportion of cancer centres fully implementing each of the 46 ASCO/ONS safety standards, grouped into four domains: (1) creating a safe environment—staffing and general policy; (2) treatment planning, patient consent and education; (3) ordering, preparing, dispensing and administering chemotherapy; and (4) monitoring after chemotherapy administration.

Of the 25 centres invited, 19 (76%) participated. The domain most frequently fully implemented was treatment planning, patient consent and education (12/19 centres, 63.2%). The remaining domains were fully implemented by four centres or fewer. The lowest implementation was observed for standards requiring policies for documentation and follow-up of patients who miss or cancel scheduled visits or chemotherapy treatments. Centres accredited by the Joint Commission International and those that specifically reported adherence to internationally recognised oncology guidelines were more likely to fully implement specific domains of the ASCO/ONS chemotherapy administration safety standards.

Significant gaps exist in the implementation of ASCO/ONS chemotherapy administration safety standards at cancer centres across Arab countries. These findings highlight opportunities for targeted interventions and policy development to improve chemotherapy safety in the region.