Background: Medical errors pose a significant threat to patient safety and healthcare quality worldwide, particularly in low- and middle-income countries. Physicians’ perceptions of error reporting and management influence the effectiveness of patient safety initiatives, yet evidence from Northwestern Nigeria is limited. Aim: To assess physicians’ perceptions of medical error reporting and management at a teaching hospital in Northwestern Nigeria. Materials and Methods: A hospital-based cross-sectional descriptive study was conducted among 191 physicians at Usmanu Danfodiyo University Teaching Hospital, Sokoto. Eight departments were selected using simple random sampling, and eligible physicians were recruited via systematic sampling. Data were collected using a structured, pretested, self-administered questionnaire and analysed with SPSS version 25. Descriptive statistics summarized sociodemographic characteristics and perceptions of error reporting and management. Results: The mean age of respondents was 36.3 ± 6.3 years, with a predominance of males (79.6%) and resident doctors (66.5%). Overwork, stress, and fatigue (63.9%), communication gaps (53.4%), and lack of teamwork (44.0%) were perceived as leading causes of medical errors. Laboratory-related (42.9%) and diagnostic errors (41.9%) were most commonly encountered. Key strategies for prevention included spending more time with patients (51.8%) and establishing structured reporting systems (45.0%). Most physicians supported constructive management responses, such as information-seeking (61.3%), reporting through appropriate channels (45.5%), and collegial discussion (36.1%), while avoidance and concealment behaviors were rare. Conclusion: Physicians generally hold positive views of medical error reporting and management, favouring learning-oriented, collaborative approaches. Strengthening structured reporting systems and supporting teamwork-based error management could further enhance patient safety in this setting.