Background: For years, specialists have been interested on the verge of documentation of adverse drug reactions because of its great importance. The countries of the Middle East have also kept pace with this mission and developed in the past years. Like any other project, this documentation process is accompanied by several problems that will negatively affect the objectives set in this area. Objective: The aim of the current study is to know the main barriers regarding the process of adverse drug reactions in the Middle East area. Patients and methods: In October 2022, a manual search of the literary databases PubMed and Google Scholar has done. The 102 articles were manually screened. Studies that have been published between 2012 and 2022 were eligible. Results: From the 102 publications that underwent manual screening, 26 research articles from 12 different countries qualified for inclusion in the study. Lack of enthusiasm, a professional atmosphere for the conduct of pharmacovigilance, a general lack of knowledge and awareness concerning pharmacovigilance and not enough time for reporting are the main barriers for adverse drug reactions. Conclusion: According to the results, the lack of knowledge or awareness of pharmacovigilance practices and the absence of mechanisms that assist recording in terms of enough time, motivation, or the environment as a whole are the two most significant causes of underreporting.