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Background: Occupational exposure to hazardous drugs is a recognised occupational risk in hospital pharmacy practice. Although international guidelines are available, the implementation is heterogeneous, and there are currently no formally endorsed national recommendations regarding the safety of pharmacy technicians in Portugal. Objective: To develop consensus-based national recommendations for the safe handling of hazardous drugs by pharmacy technicians in Portugal. Methods: A modified Delphi study was conducted involving 43 invited experts from Portuguese hospital pharmacies. Fifty-eight statements were evaluated using a 0-10 agreement scale through one formal quantitative round, followed by a structured online consensus validation meeting and documentary confirmation. Consensus was predefined as a median score >7. Results: Thirty-six experts completed Round 1 (response rate 83.7%). All 58 statements voted on in Round 1 achieved consensus, with median scores of 10 for all recommendations and 98% of ratings ≥7. Following consolidation and merging procedures, the final set comprised 55 recommendations. The final recommendations were organised into five domains: occupational health surveillance, engineering controls and PPE, preparation technique and quality assurance, administrative safeguards, and environmental contamination and waste management. Conclusions: This study establishes the first structured national consensus on the safety of hazardous drug handling for pharmacy technicians in Portugal. The resulting framework supports harmonisation of institutional practices, strengthens occupational risk governance, and provides a foundation for future implementation and evaluation studies.