Introduction: Needlestick injuries (NSIs) are common occupational hazards against healthcare workers (HCWs). NSIs led to serious economic burden as there were high costs forhealth system and the society, as well as the psycholog-ical impact on exposed workers post injury. Methods: A retrospective cohort study was conducted to determine the incidence, contributing factors of NSIs and to estimate the cost of PEM in Sabah’s tertiary hospitals. Descriptive statis-tics were used to analyse and describe the trends of NSIs. Chi-Square test was performed to determine the association between variables, relative risk was calculated. Results: 145 cases out of 7075 employees were reported from 2017 to 2018. Results in this study showed that the highest incidence of NSIs was 2.4/100 employees in Hospital Queen Elizabeth. 1.1/100 employees in 2018, which was higher compared to year 2017. Most common among younger age group between 20-29 years old, among doctors, with median working experience of 2 years. NSIs occurred com-monly at the wards, during blood taking, disposal of devices and common device used were hypodermic needles. There was a lack of awareness on NSI precaution guidelines among the doctors (χ2=19.304, df=1, p=