Abstract: OBJECTIVE To discuss the application effect of health care failure mode and effect analysis(HFMEA) and root cause analysis(RCA) in the intelligent management of narcotic use in the hospital. METHODS Set up an analysis team to use HFMEA to list potential failure modes in the flow chart of intelligent management of narcotic use in the hospital, and analyze and evaluate the key failure modes in combination with RCA, determine the root cause, and then formulate improvement measures and evaluate the effects after implementation. RESULTS After the implementation of the improvement measures, the risk priority number of the eight potential failure modes decreased significantly(P<0.05). The satisfaction of pharmacists, doctors and nurses with the intelligent management process of narcotic use in the hospital increased from (88.39±2.21)% to (98.04±0.51)%, from (87.79±1.36)% to (97.55±1.24)%, and from (90.79±1.39)% to (95.68±1.30)%, respectively. CONCLUSION HFMEA combined with RCA can reduce the risk of narcotic drug abuse, ensure drug quality and safety, reduce the occurrence of dispensing errors, and ensure the rational clinical use of narcotic drugs.