The increasing incidence of cancer in sub-Saharan Africa, particularly in Côte d'Ivoire with 17,300 new cases reported in 2020, has motived improvements in patient care, marked by the establishment of a National Centre for Medical Oncology and Radiotherapy. This study aimed to evaluate compliance with international standards regarding the safe handling of cytotoxic drugs, which pose risks to healthcare personnel, patients, and the environment. The methodology encompassed all stages of the anticancer drug management circuit. Failure modes in management that could lead to risks, particularly during the handling of anticancer drugs, were analyzed using the Failure Mode, Effects, and Criticality Analysis (FMECA) method. These failure modes or non-compliant practices were previously identified using the Cyto-SAT tool, which is adapted for evaluating anticancer drug handling practices in low- and middle-income countries. The median compliance rate with good practices was 69%. Among all identified or potential failures, 61 risks were identified. Regarding processes directly involving pharmaceutical activities, specifically logistics and preparation, 21 risks were prioritized. Twenty-seven actions were defined to control them. During the study, the rate of safe practices at the CNRAO was higher than the average rate in low-income countries and that of middle-income countries. For a new centre, the CNRAO shows promising results. It is essential to continue and improve the implementation of safe handling practices to protect both patients and healthcare staff.