Clinical study reports (CSRs) are essential for regulatory submissions for marketing authorisation, with the safety section playing a critical role in assessing patient risk and guiding approval decisions. Traditionally, in-text safety tables are created manually, a process prone to inefficiencies and errors. This article proposes the adoption of immutable table technology – read-only data structures that preserve original content and prevent unauthorised changes – to enhance the accuracy, integrity, and efficiency of CSR development. We compare mutable and immutable tables, demonstrating how the immutable tables reduce the risk of data tampering and streamline review processes. A proposed workflow, best practices, stakeholder responsibilities, and anticipated challenges are discussed. While implementation requires initial investment in training and setup, the long-term benefits include improved data reliability and regulatory compliance. This approach supports not only safety data presentation but also efficacy results, contributing to high-quality, reliable CSRs for successful marketing authorisation.