Objectives To enhance occupational safety for medical practitioners involved in acupuncture procedures within the field of Chinese medicine， it is imperative to thoroughly investigate and analyze the current incidence of accidental punctures. Subsequently， effective strategies can be proposed to prevent such occurrences. Methods Through retrospective analysis， this study investigates the occupational exposure data of a tertiary hospital specializing in traditional Chinese medicine from 2020 to 2022. The demographic characteristics （age and gender）， professional experience， occupational category， pre-service training， type of acupuncture tools used， puncture session details， and exposure sources of the individuals involved are collected and organized for analyzing the risk factors associated with accidental needlestick injuries. Corresponding preventive measures are proposed accordingly. Results In this survey， a total of 5 069 medical staff from 12 clinical departments were included， among whom 63 experienced accidental puncture with an incidence rate of 1.24% （63/5 069）. The likelihood of puncture was found to be significantly higher in individuals aged between 25 ~ 30 years compared to those under the age of 25 （OR = 18.556， P < 0.05）. Similarly， the probability of puncture was also higher in individuals aged over 30 years compared to those under the age of 25 （OR = 14.311， P < 0.05）. Conversely， individuals with at least three years of experience had a lower probability of experiencing punctures compared to those with less than three years （OR = 0.025， P < 0.05）. Furthermore， interns exhibited a higher likelihood of puncture incidents compared to physicians （OR = 2.212， P < 0.05）. Regarding the puncture session， the highest probability of occurrence is 58.73% at the time of needle removal （χ² = 106.222， P < 0.05）. Regarding the type of acupuncture tools， acupuncture needles have the highest probability of occurrence at 41.27% （χ² = 45.095， P < 0.05）. Concerning the exposure source， "unknown exposure source" has the highest prevalence at 42.86% （χ² = 57.476， P < 0.05）， while "exposure source is hepatitis B patient" accounts for 20.63% （χ² = 57.476， P < 0.05）. Regarding pre-service training， individuals who have received pre-service training exhibit a higher likelihood of puncture incidents （69.84%） （χ² = 38.000， P < 0.05）. Conclusions The serological status of patients should be obtained in advance， and strict adherence to infection prevention control measures such as "standard precautions" and "contact isolation" is necessary. Effective pre-service training must be implemented， with particular attention given to the risk of puncture when using specialized acupuncture tools for occupational safety.