Objective To analyze the epidemiological characteristics, causes and disposal of blood-borne occupational exposure of health care workers (HCWs) in a tertiary traditional Chinese medicine hospital, and provide reference for reducing exposure risks. Methods Data on blood-borne occupational exposure reported by a traditional Chinese medicine hospital from January 2014 to December 2023 were collected retrospectively, and analyzed descriptively. Results The reported incidence of blood-borne occupational exposure among HCWs from 2014 to 2023 was 3.08% (527/17 098). Among them, 55 cases had damaged skin or mucous membrane exposure, with an incidence of 0.32%; 472 cases had sharp device injuries, with an incidence of 2.76%. Difference between the two was statistically significant (χ²=335.125, P＜0.001). The main characteristcs of blood-borne occupational exposures were sharp device injuries (89.56%), female (83.49%) , HCWs with less than 5 years of service (42.69%) and intermediate professional titles (67.93%). Damaged skin or mucous membrane exposure mainly occurred in doctors (58.18%), while sharp device injury occurred mainly in nurses (73.73%). Department of internal medicine had the highest exposure to sharp device injuries (42.80%), and operating room had the highest damaged skin or mucous membranes exposure (47.27%). The main occurrence timing of sharp device injuries were needle pulling (21.82%), disposal of used sharp devices and randomly placed sharp devices (20.34%), as well as injection, puncture, acupuncture, tube sealing or blood collection (19.49%). 71.73% exposure sources were clear, and the top three detected blood-borne pathogens were hepatitis B virus (70.86%), hepatitis C virus (11.92%), and Treponema pallidum (9.27%). The correct disposal rate after exposure was 88.05%. Conclusion From 2014 to 2023, blood-borne occupational exposure in this traditional Chinese medicine hospital was mainly caused by sharp device injuries. Nurses experienced more incidents during needle pulling and sharp device handling. Damaged skin or mucous membrane exposure was mainly due to splashing patient’s blood into the eyes of doctors during surgery.