Objective To explore the impact of clinical nurses’ reflective practice on their medication safety competence，and provide reference for cultivating nurses’ medication safety competence. Methods Cross-sectional study design was adopted by convenient sampling. In 2022，clinical nurses from five grade Ⅲ hospitals in Zhengzhou were recruited and investigated by the general information questionnaire，the Chinese version of the Reflective Practice Questionnaire，and the Chinese version of the Medication Safety Competence Scale. Results A total of 1 127 valid questionnaires were collected，with the effective recovery rate was 87.16%. The total score of the nurses’ reflective practice was（128.97±16.07），and the total score of the medication safety competence was （138.39±25.13）. Pearson correlation analysis showed that reflective practice was positively correlated with medication safety competence（r=0.579，P<0.001）. Multiple linear regression analysis found that reflective practice was the influencing factor of clinical nurses’ medication safety competence（β=0.577，P<0.001），explaining 33.2% of the total variation（F=150.674, P<0.001） independently. Conclusion Reflective practice has a positive impact on the ability of clinical nurses to use drug safely，which could be improved by enhancing reflective practice.