OBJECTIVE: To analyze clinical characteristics, incidence, and distribution of drug associated muscle adverse reaction (DAMAR) in real world inpatients, to provide references for clinical medication use. METHODS: Automated retrospective monitored inpatients from 2022-5-1 to 2023-4-30 to obtain information about patients’ adverse reactions and analyze. RESULTS: There were 1106 DAMARs among 102430 hospitalizations, with an incidence of 1.08%, in which 125 cases of rhabdomyolysis with an incidence of 0.12%. 75% of the patients experienced muscle adverse reactions within 5 days after medication, and the median value of elevated CK was 420.4 IU/L. There was no significant correlation between duration of surgery and the elevation of CK, while the surgical procedure had an effect. Age, male sex, obesity, hypertension, hepatic and renal insufficiency, anemia, and other underlying diseases were risk factors. The 114 drugs involved were mainly nervous system drugs, antiinfectives for systemic use and cardiovascular system drugs, with levofloxacin, pregabalin and parecoxib being the drugs with the highest number of cases. CONCLUSION: Attention should be paid to patients with the above risk factors. Monitor creatine kinase and related indexes when using myotoxic drugs, to avoid the occurrence of serious adverse reactions, which may affect the patients’ quality of life.