Objective To explore the adverse drug event (ADE) signals associated with paclitaxel for injection (albumin bound) in the real world, in order to provide references for clinically rational and safe medication.Methods ADE reports of paclitaxel for injection (albumin bound) from the first quarter of 2004 to the third quarter of 2023 were retrieved from the FDA Adverse Event Reporting System (FAERS). The reporting odds ratio (ROR) method and the Bayesian confidence propagation neural network (BCPNN) method were used to find signals and study how ADEs happen in the real world.Results A total of 200 ADE signals were detected, involving 22 system organ classes (SOC), with 5 061 reports in total. A higher proportion of reports were from females than from males, and the reports were mainly from individuals aged 45 and above. The accumulated SOCs mainly included general disorders and administration site conditions (23.43%), blood and lymphatic system disorders (18.55%), gastrointestinal disorders (10.06%), various examinations (8.32%), metabolic and nutritional disorders (5.97%), and various neurological disorders (5.10%), etc. Neutropenia, anemia, thrombocytopenia, febrile neutropenia, peripheral neuropathy, and sepsis were the ADE signals that were reported the most. On the other hand, ADE signals with strong correlation mainly included biliary infection, peripheral sensory neuropathy, immune-mediated hepatitis, bile duct stenosis, macular edema, etc. A total of 30 new suspected adverse reactions (ADR) not recorded in the drug instruction were found, mainly including lymphopenia, changes in mental status, hyperglycemia, esophagitis, multiple neuropathies, etc.Conclusion The common adverse reactions of paclitaxel for injection (albumin bound) in the real world were consistent with those listed in the drug instruction, but there were some newly discovered suspected adverse reactions. These should be paid special attention to in clinical medication.