Background <p>Adverse drug reactions (ADRs) are a significant cause of morbidity and mortality worldwide, reflecting a critical need for effective pharmacovigilance. Pharmacovigilance ensures drug safety by monitoring, assessing, and preventing the occurrence of ADRs. Healthcare professionals are pivotal in this system because of their interactions with patients and medications. Understanding their knowledge, attitudes, and practices toward pharmacovigilance is crucial for identifying gaps and enhancing initiatives for drug safety.</p> Objective <p>To evaluate the knowledge, attitudes, and practices of pharmacovigilance among healthcare professionals at Atbara Teaching Hospital, identify the reasons for the underreporting of ADRs, and determine if there is a significant association between pharmacovigilance training and ADR reporting.</p> Methods <p>This descriptive cross-sectional study was conducted at Atbara Teaching Hospital via a stratified simple random sampling method. Data was collected using a self-administered questionnaire consisting of demographic data and a knowledge, attitude, and practice section. The data were analyzed via the Statistical Package for Social Sciences (SPSS) to determine associations between various variables.</p> Results <p>A total of 122 healthcare professionals participated in the study. The knowledge of pharmacovigilance among the participants was moderate, with a mean knowledge score of 5.1 ± 1.9 out of 12. The definition and primary purpose of pharmacovigilance were correctly identified by 67.2% and 69.7%, respectively, and the definition of adverse drug reaction was identified by 54.1%. Notably, only 23.8% were aware of the existence of pharmacovigilance program in Sudan. The participants showed a generally positive attitude toward pharmacovigilance with a mean score of 7.7 ± 2.0 out of 12. A total of 95.1%, agreed with the necessity of ADR reporting and 79.5% believed that pharmacovigilance should be taught to all healthcare professionals. The practice of ADR reporting was lacking; although 66.4% of the participants had observed an ADR during their professional practice, only 18.9% reported it. This imbalance between the ADR observed and reported was attributed to several barriers, mainly due to unawareness of how and where to report an ADR and the lack of incentives for reporting. The study revealed a significant association between pharmacovigilance training and ADR reporting.</p> Conclusions <p>While healthcare professionals exhibited adequate knowledge, and favourable attitudes toward pharmacovigilance, practical reporting rates were low. Targeted training, streamlined reporting mechanisms, and policy interventions are recommended to bridge this gap and enhance drug safety.</p>