Clinical Decision Support Systems (CDSSs) have emerged as vital instruments in oncology settings, particularly for nursing professionals managing high-risk cancer medications. As cancer incidence continues to rise globally, the complexity and toxicity of anticancer therapies necessitate robust mechanisms to ensure patient safety. This review explores the use of CDSSs by oncology nurses to monitor high-risk medications, focusing on their role in identifying dosage errors, contraindications, and potential toxicity. A narrative literature review was conducted using key databases, targeting studies from the last decade that examined CDSSs applications in oncology nursing. The analysis identified recurring themes related to medication safety, user experience, integration into clinical workflow, and educational implications. While CDSSs significantly contribute to error reduction and improved clinical judgment, challenges such as system interoperability, alert fatigue, and limited nurse-specific customization were noted. The findings emphasize the need for continuous development and tailored implementation of CDSSs to optimize their utility in oncology nursing practice. Clinical implications include enhanced patient safety, improved nurse confidence in medication management, and the potential for data-driven nursing education. Future directions suggest more comprehensive integration of artificial intelligence and machine learning algorithms into CDSSs, increased interdisciplinary collaboration in tool design, and further research on long-term clinical outcomes. This review underscores the importance of digital support tools in enhancing oncology nursing practice, ultimately contributing to better patient outcomes..