Background: Evaluate the patient's safety status in Iranian hospitals using the Patient safety friendly hospital initiative (PSFHI) assessment tool provided by the World Health Organization. PSFHI assessment tool of 140 patient safety standards, they are classified as mandatory (20 standards), basic (90 standards) and advanced (30 standards). Mandatory standards are necessary criteria that hospitals must meet to register for PSFHI. The first stage of the patient safety program in Iran is to achieve the implementation of the mandatory standards to enter the patient safety friendly hospital program. We aimed to evaluate the patient's safety status in Iranian hospitals in terms of implementing mandatory patient safety standards. Methods: In this systematic review, articles were searched between 2001 and 2021 in Web of Science, PubMed, Scopus Google Scholar, and Iranian SID and Magiran databases. Keywords including patient safety, quality assessment, standards, patient safety friendly hospital, Iran were performed. These articles were evaluated independently by two researchers and the contradictions were discussed with the third author. Results: Finally, 7 eligible studies were included in the study. The highest score (75%) was related to the fourth domain of safe environment and the lowest score with (47%) was related to the second domainof engaging and interacting with the patient and the community. The overall average of compliance with standards in . all four areas was 70%. Conclusion: Institutionalizing a patient safety culture, paying more attention to creating a culture to identify patients, educating staff and patients, and removing legal barriers, Increases the observance of mandatory patient safety standards in the Iran.