Background: Healthcare workers (HCWs) are at increased risk of infection with bloodborne pathogens due to occupational blood exposures (OBEs). Early reporting, detection and postexposure prophylaxis (PEP) help to prevent infections. Aim: To investigate the incidence of OBEs, related epidemiological characteristics, PEP completion rate, time and reason for PEP discontinuation, and seroconversion rate reported over 10 years. Methods: This retrospective study analysed 1086 cases of OBE and PEP management from January 2012 to December 2021 among staff in a South Korean tertiary hospital. Findings: The mean incidence of OBE was 7.82 per 100 beds and 3.0 per 100 HCWs. Of 1086 cases of OBE, 633 (58.3%) HCWs required PEP and 453 (41.7%) did not. After OBE, 70.1% (444/633) of HCWs subject to PEP completed tracking, and 29.9% (189/633) stopped PEP tracking (P<0.001). The PEP completion rate showed a significant difference by gender (P1/40.024), occupation (P<0.001) and exposure frequency (P<0.001). None of the 444 HCWs who completed PEP seroconverted to hepatitis B virus, hepatitis C virus, human immunodeficiency virus or Treponema pallidum (syphilis). Conclusion: The study findings demonstrate the need to improve follow-up care among HCWs following OBE. There is a need for education in healthcare facilities; moreover, establishing a national surveillance system is necessary to ensure that HCWs undergo PEP proactively and complete their follow-up visits. & COPY; 2023 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.