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Accidental exposure to blood-borne pathogens (BBPs) is a risk for health care workers (HCWs).To study the pattern of occupational exposure to blood and body fluids (BBFs) at a tertiary care hospital.This study reports a 17-year experience (1985–2001) of ongoing surveillance of HCW exposure to BBFs at a 420-bed academic tertiary care hospital.A total of 1590 BBF exposure-related accidents were reported to the Infection Control Office. The trend showed a decrease in these exposures over the years with an average ± standard error of 96 ± 8.6 incidents per year. In the last 6 years, the average rate of BBF exposures was 0.57 per 100 admissions per year (average of needlestick injuries alone was 0.46 per 100 admissions). For 2001, the rates of exposure were found to be 13% for house officers, 9% for medical student, 8% for attending physicians, 5% for nurses, 4% for housekeeping, 4% for technicians and 2% for auxiliary services employees. The reason for the incident, when stated, was attributed to a procedural intervention (29%), improper disposal of sharps (18%), to recapping (11%) and to other causes (5%).The current study in Lebanon showed that exposure of HCWs to BBPs remains a problem. This can be projected to other hospitals in the country and raises the need to implement infection control standards more efficiently. Similar studies should be done prospectively on a yearly basis to study rates and identify high-risk groups.