The Iranian healthcare system, despite notable scientific and technological advancements in recent decades, continues to face deep structural and cultural challenges in addressing human error. This paper, through an analytical–comparative approach, examines the root causes of medical errors across four fundamental dimensions: the absence of a unified and effective supervisory system, a shortage of qualified human resources, weak implementation of standardized protocols, and insufficient practice-oriented and interdisciplinary training. Findings indicate that institutional fragmentation, overlapping responsibilities, and a blame-oriented rather than learning-oriented culture have prevented the establishment of transparent reporting mechanisms and root-cause analyses. Furthermore, the human resource crisis—driven by workload pressure, professional burnout, migration of skilled personnel, and a lack of effective incentive structures—has severely affected the quality of clinical care. In addition, formal medical education in Iran remains largely disconnected from the real needs of the healthcare environment, neglecting essential non-technical skills such as teamwork, crisis decision-making, and effective communication. This study, by comparing successful international models in patient safety and human error management, highlights the urgent need for a national integrated monitoring framework, a redefinition of educational policies, and the strengthening of a “just culture” in healthcare—one in which errors are not concealed but regarded as opportunities for learning and systemic improvement.