This document provides guidance on assessing whether adverse reactions are expected or unexpected based on the applicable reference safety information. It defines expectedness at both the event and case levels. An event is considered unexpected if it is more specific, severe, serious, or accompanied by additional signs/symptoms than described in the reference safety information. The appropriate reference safety information to refer to depends on whether the product is in the premarketing or postmarketing phase. The document also provides examples and clarification on expectedness in various situations like drug interactions, medication errors, product quality issues, pregnancies, and overdoses.