Objectives To describe current use of electronic prescribing (EP) in English acute NHS hospital trusts, and the use of multiple EP systems within the same hospital. Design Descriptive cross-sectional postal survey. Setting Acute NHS hospital trusts in England. Participants The survey was sent to chief pharmacists in all acute English NHS hospital trusts in 2011. Where trusts comprised multiple hospitals, respondents were asked to complete the questionnaire for their main acute hospital. Main Outcome Measures Prevalence of EP use in acute NHS hospitals; number of different EP systems in each hospital; stages of the patient pathway in which EP used; extent of deployment across the hospital; comprehensiveness regarding the drugs prescribed; decision support functionalities used. Results We received responses from 101 trusts (61%). Seventy (69%) respondent hospitals had at least one form of EP in use. More than half (39;56%) of hospitals with EP had more than one system in use, representing 60 different systems. The most common were systems used only for discharge prescribing, used in 48 (48% of respondent hospitals). Specialist chemotherapy EP systems were second most common (34; 34%). Sixteen specialist inpatient systems were used across 15 hospitals, most commonly in adult critical care. Only 13 (13%) respondents used inpatient electronic prescribing across all adult medical and surgical wards. Overall, 24 (40%) systems were developed ‘in-house’. Decision support functionality varied widely. Conclusions It is UK government policy to encourage the adoption of EP in hospitals. Our work shows that EP is prevalent in English hospitals, although often in limited clinical areas and for limited types of prescribing. The diversity of systems in use, often within the same hospital, may create challenges for staff training and patient safety.