Disclosed is an automatic tablet dispensing and packaging device to simultaneously and automatically package tablets corresponding to a plurality of prescriptions by one device without additionally purchasing a plurality of automatic tablet dispensing and packaging devices for the prescriptions. The automatic tablet dispensing and packaging device includes a plurality of sliding racks, each of which including a plurality of tablet cassettes provided therein, and a plurality of discharge passages are provided between the tablet cassettes, a plurality of packaging units provided under the sliding racks corresponding to the sliding racks, and a transferring unit coupling the sliding racks to the packaging units to guide the tablets discharged from the sliding racks such that the tablets are transferred to corresponding packaging units in cross each other.