In an article published in the journal JRSM Open, we discuss patient safety in developing countries. Through a review of the literature, lessons and interventions from developed countries have been taken into consideration to identify the themes needed for patient safety improvement. We provide an integrated approach based on best practice which can be used to guide the development of a national strategy for improving patient safety. Policy makers need to focus on developing a holistic and comprehensive approach to patient safety improvement that takes into account the themes discussed in this article.