Background: Needlestick and sharp injuries (NSSIs) are significant occupational hazards for healthcare workers (HCWs), facilitating the transmission of bloodborne pathogens such as HIV, hepatitis B, and C viruses. Despite known risks, the frequency and associated factors contributing to these injuries in healthcare settings, particularly in developing countries, are not well-documented. Objective: This study aimed to determine the frequency of NSSIs, identify their associated risk factors, and evaluate the safety measures adopted by HCWs in a tertiary care hospital in Rawalpindi, Pakistan. Methods: A cross-sectional study was conducted from May to September 2022 at Fauji Foundation Hospital, Rawalpindi. A total of 250 HCWs, including paramedical staff, doctors, nurses, and allied health professionals, participated in the study. Ethical approval was obtained from the Center of Advanced Studies in Health and Technology research committee and the Head of the Department of Pathology. A structured questionnaire was developed to collect data on demographic characteristics, history of NSSIs, risk factors, and safety measures adopted post-injury. Data were analyzed using SPSS version 25, employing non-parametric tests due to the non-normal distribution of data. Results: Among the participants, 76.8% (n=192) reported experiencing NSSIs at least once during their employment. The highest incidence of NSSIs was observed among HCWs aged 26-30 years (31.6%, n=79) and those with 2-7 years of work experience (50.4%, n=126). The most common risk factors for NSSIs were heavy workload (40%) and recapping of needles (22%). Only 38% (n=95) of HCWs reported the incident, and 44% (n=111) were vaccinated against hepatitis B following exposure. Moreover, 58% (n=145) used personal protective equipment, and 73.6% (n=184) utilized safety boxes for sharp waste disposal post-injury. Conclusion: The study highlights a high prevalence of NSSIs among HCWs, with inadequate reporting and post-exposure prophylaxis. There is a critical need for enhanced training on safe handling of sharps and increased adherence to universal precautions to mitigate the risk of NSSIs in healthcare settings.