Objective To study the occurrence characteristics, emergency response, follow-up information as well as prevention and control cost of occupational exposure to blood-borne pathogens, and provide reference to formulating prevention and control strategies of occupational exposure in hospital. Methods Occupational exposure events of blood-borne pathogens reported from January 1, 2016 to December 31, 2020 in a tertiary first-class maternal and child health hospital were collected and analyzed retrospectively. Exposed persons who didn't complete the whole process of inspection and tracing were with telephone follow-up. Results There were 149 cases of occupational exposure to blood-borne pathogens. Incidence density of cleaning staff was the highest (0.036 cases/person/year), followed by nurses (0.031 cases/person/year), both were higher than that of doctors (0.018 cases/person/year) and medical technicians (0.005 cases/person/year) (P < 0.001). Incidence density of occupational exposure of nurses and doctors with junior and lower professional titles were higher than those with intermediate and senior professional titles (P < 0.001). Operating room was the location with the highest incidence (25.50%). Sharp instrument injury was the main exposure type (85.23%). Occupational exposure occurred most frequently during the disposal process of medical waste (34.90%). Hepatitis B virus is the most frequently exposed pathogen (20.81%). 10am-12am was the peak time of occupational exposure (28.86%). Hand was the most exposed site (82.55%), and injuries occurred more often in non-dominant hand (46.98%) than in dominant hand (35.57%). Index finger was the most common site of hand injury (42.28%). The top three causes of occupational exposure were careless operation (48.99%), accident or emergency (20.80%), and improper handling of sharp instruments by others (15.44%). 6.04% exposed persons had nonstandard emergency response, and 20.13% cases delayed reporting. The implementation rate of full tracing after occupational exposure was 41.89%, and the top three reasons for it were forgetting, not paying enough attention and wrong cognition. The total cost of the prevention and control after occupational exposure was 20 926.10 Yuan, with an average cost of 140.44 Yuan per case. The average cost of unknown exposure sources was the highest (273.70 Yuan per case). Conclusion Considering the characteristics of high-risk groups, locations, links, time and sites, as well as the high rate of delayed reporting and low implementation rate of full tracing of occupational exposure to blood-borne pathogens, it is necessary to take effective measures to reduce the occurrence of occupational exposure and decrease the risk of infection after exposure, thus ensure the occupational safety of hospital staff.