The rapid evolution of healthcare demands urgent advancement in pharmacy robotics and automation to enhance patient safety, reduce medication errors, and address the rising financial burden on health systems. Despite the United States spending 17.8% of its GDP on healthcare—significantly higher than other developed nations—preventable medical and medication errors remain prevalent. Automation is widely perceived as a promising solution, yet existing evidence reveals inconsistent outcomes and insufficient rigorous evaluation. Technologies such as bar-code medication administration, automated dispensing cabinets, pharmacy carousels, intravenous (IV) workflow systems, and IV compounding robots have demonstrated selective improvements, particularly in workflow standardization and staff safety. However, many studies lack robust design, standardized metrics, or clinically meaningful outcomes. Instances of unintended consequences—device-related failures, workflow mismatches, and new categories of errors—highlight the need for systematic assessment and post-deployment monitoring. The current literature is dominated by single-center, descriptive reports influenced by implementation variability, limiting generalizability. To ensure safe and cost-effective adoption of pharmacy automation, the field must adopt scientific evaluation standards comparable to the drug approval process, including randomized trials, multicentre studies, standardized definitions of medication errors, and rigorous outcome measurement. Collaboration between professional organizations, technology vendors, policy bodies, and pharmacy leaders is essential to develop unified assessment frameworks and ensure transparent reporting of both positive and negative findings. This article calls for an evidence-driven transformation in the evaluation and deployment of pharmacy robotics to support safe, efficient, and economically sustainable medication-use systems.