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Aim: The aims were to characterise paediatric medication errors and to identify the prevalence of known high‐alert substances in these errors. Methods: All paediatric drug‐related incident reports and complaints nationally reported to the Health and Social Care Inspectorate in Sweden 2011‐2017 regarding inpatients were characterised by context and modal details. In addition, drug use at a university hospital was matched to local incident reports. Drug substances were classified using three high‐alert lists. Results: On a national level, there were 160 reports (2.5 per 10 000 patients) in which the three high‐alert lists were found in different degrees (17/35/47%). Morphine (n = 12), vancomycin (n = 11) and potassium (n = 7) were most frequently involved. Eighty per cent of the reports concerned patients aged 0‐6 years. Intravenous was the most common route of administration (66%). On a university hospital level, the prevalence of all types of drug incidents reports was 1.7% among all inpatients. The prevalence of local incident reports involving high‐alert substances was almost double that of non‐alert substances. Conclusion: Existing high‐alert drug lists are relevant for paediatric inpatients. A higher awareness and usage of such lists among hospital staff prescribing, dispensing and administering drugs to children may have the potential to reduce medication errors. [ABSTRACT FROM AUTHOR]