Objective To investigate and analyze the current situation and causes of occupational exposure to acupuncture needles among health care workers (HCWs). Methods A self-designed questionnaire was used to retrospectively investigate the occurrence of occupational exposure to acupuncture needles among HCWs in 27 clinical departments of a tertiary traditional Chinese medicine hospital within the past three years, and to compare and analyze the relevant information. Results Among 1 585 HCWs surveyed, a total of 164 HCWs experienced 231 times of occupational exposure to acupuncture needles, with an incidence of 10.35%. Incidences of occupational exposure of HCWs of different ages, work experience, and professional categories showed statistical differences (P < 0.001), with the highest incidences occurred among medical students (including interns, visiting scholars, and resident physicians), HCWs under 25 years old, and HCWs with less than one year of work experience. The main type of puncture needle involved in the 231 incidents was the fine needle (106 times, 45.88%). Injury occurred mostly during the process of removing needle (68 times, 29.44%) and mainly in the ward (82 times, 35.50%). Among all the incidents, 176 cases (76.19%) were properly treated according to regulations, and 148 cases (64.07%) were reported timely. Conclusion Incidence of occupational exposure to acupuncture needles among HCWs in traditional Chinese medicine hospital is relatively high. Measures should be taken to strengthen the occupational protection training and assessment for medical students and new staff, to standardize the operating procedures for using needles, thus further prevent and reduce the incidence of occupational exposure to acupuncture needles among HCWs.