Medication errors happen frequently in hospital, home, and pharmacy environments. A medication verification and dispensing system provides protection against such errors. The apparatus includes a guide tube that receives a medication and imaging device(s) adjacent to the guide tube that take image(s) of the medication. The imaging devices(s) and light source(s) are oriented for capturing images that reveal markings, color, size, shape, etc., of the medication. A verification system uses a signature of the image to identify the medication or compares the image(s) to reference images to identify the medication and to a prescription record of the patient to ensure it is a correct medication, dose, amount, timing, etc., for administration. If the medication is correct, it is dispensed into a dispensing vessel that locks the medication inside, but unlocks when it recognizes a unique patient identifier worn by a patient that is a correct recipient for the medication.