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Abstract Background Routinely collected prescribing and medicine-related data in Scotland are comprehensive and of high quality. However, they are generated across multiple healthcare settings and stored in complex source systems that are not optimised for longitudinal or outcomes-focused research. To maximise the research value of these data, there is a need for curated, analysis-ready resources that provide consistent representations of medicines exposure and enable linkage to clinical outcomes. The Medicines in Acute and Chronic care Scotland (MACCS) provides standardised, curated medicines data to support longitudinal analyses of medicine-related exposure across NHS healthcare systems. Methods MACCS resource is a national individual-level medicines dataset for adults (18 years of age and older), derived from routinely collected prescribing and medicine-related data held by Public Health Scotland (PHS). It integrates data from the Hospital Electronic Prescribing and Medicines Administration (HEPMA), Prescribing Information System (PIS), and Homecare Medicines (HCM) datasets, which are linked at the individual level to eleven other national clinical records; including Scottish Morbidity Records (SMR00/01/02/04/06), laboratory data and mortality records; using the unique NHS Scotland person identifier. Data are curated, harmonised and pre-linked within the National Safe Haven and accessed by approved researchers through secure Trusted Research Environments. Results MACCS contains individual-level information on adults receiving NHS Scotland care, including patient demographics (such as age, sex and geographical indicators) and detailed records of medicines prescribing in community pharmacies as well as those administered in hospitals and through homecare services. Medicines-related data captures exposure dates and, where available, details on formulation, strength and dose. In addition, MACCS includes cancer registry data, renal registry data, laboratory test results, microbiology surveillance and mortality records. The earliest dates of data availability vary by source dataset. Conclusion MACCS provides a sustainable, longitudinal medicines research resource that simplifies access to complex national prescribing data and enables robust linkage to health outcomes. By supporting population-scale analyses across care settings, MACCS enhances the capacity for high-quality research to inform clinical practice, health policy, and medicines optimisation in Scotland. Key Features The Medicines in Acute and Chronic Care in Scotland (MACCS) data resource was established in 2025 to integrate medicine-related data with other electronic data from Scottish healthcare systems, creating a national, linked, routinely updated data resource at population level. MACCS provides pre-linked data from multiple routinely collected national datasets within NHS Scotland including, but not limited to, prescribing records, hospital episodes, laboratory results, and death records, within a single secure environment. MACCS includes patient demographics, data on medicines prescribing and administration/supply, key biochemistry and haematology test results (e.g., kidney and liver function tests), data on hospital admissions and surgical procedures, and date and cause of death. The data resource provides longitudinal follow-up of the adult population (≥18 years of age) receiving medicines through NHS Scotland since 2010, covering approximately 4.6 million individuals, and supports pharmacoepidemiological studies, drug utilisation research, pharmacovigilance projects, as well as health services research. Approved researchers can apply through a streamlined process to access the linked MACCS data resource through established NHS Scotland governance processes, with data accessed within a Trusted Research Environment.