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Background: Ceftriaxone is a third-generation cephalosporin widely used for serious infections. Immediate hypersensitivity reactions, including urticaria and anaphylaxis, though rare, can be life-threatening. Objectives : To describe the clinical presentation, management, and outcomes of three ceftriaxone-induced adverse drug reactions (ADRs) in a tertiary medicine ward. Methods: Three inpatients with suspected ceftriaxone ADRs were identified through bedside observation and medical record review. Onset, vitals, interventions, and outcomes were documented. Causality, severity, and preventability were assessed using Naranjo scale Results: ADRs occurred within 5–20 minutes of intravenous ceftriaxone. Presentations ranged from pruritus to life-threatening angioedema with hypotension. Management included immediate drug discontinuation, antihistamines, corticosteroids, oxygen, and intravenous fluids. All patients had favorable outcomes. Causality was probable in two cases and possible in one; severity ranged in Naranjo scale Conclusion: Immediate hypersensitivity reactions to ceftriaxone require rapid recognition and intervention. Pre-administration readiness and systematic ADR reporting are key components of patient safety and antimicrobial stewardship