Introduction: Healthcare workers (HCWs) are exposed to occupational blood and body fluid exposure (OBBE) that potentially cause blood-borne infection such as HIV, Hepatitis B and Hepatitis C, with risk of transmission 0.3%, 6 to 30% and 0-10% respectively. They are exposed to these infections through percutaneous injury, splash exposure of blood and body fluids to mucous membrane and non-intact skin. Aim of this study was to determine prevalence and risk factors associated with occupational exposure of blood and body fluid in a tertiary government hospital in Sabah. Methods: A cross sectional study was conducted involving 10 places, was chosen by stratified random sampling and involved various job categories (specialist, medical officer, house officer, nurse, hospital assistant and Sedafiat worker). Self-administered questionnaire used as study tool. The data was analysed by using SPSS version 22.0. Association of risk factors and OBBE incidence were determined by Chi-square test and simple logistic regression. Results: A total of 334 respondents involved in this study. Prevalence of OBBE was 25.2% with 95% CI of 20.6% to 30.2% and highest (41.3%) among HCWs working in medical ward. Nurses were less likely to have occupational exposure to blood and body fluids (Crude OR=0.33, 95% CI: 0.20, 0.57). Needle recapping (Crude OR=3.77, 95% CI: 1.99, 7.10) and never attend training in infection prevention (Crude OR=3.19, 95% CI: 1.69, 6.05) were associ-ated with higher odds of OBBE. There was 76.3% of respondents adhere to universal precaution. HCWs who did not work in shift (Crude OR=3.04, 95% CI: 1.49, 6.21) and non-nurses (Crude OR=2.04, 95% CI: 1.06, 3.92) profession had better adherence to universal precaution. Conclusion: Prevalence of OBBE was 25.2%. Modifiable risk factors for OBBE were identified including needle recapping and training on infection prevention. Shift work is associated with adherence to universal precaution. Adequate training, increasing knowledge and awareness may help to reduce OBBE burden.