Abstract: Background: Needle stick injuries (NSIs) are among the most common occupational hazards for healthcare workers (HCWs), leading to the risk of transmission of blood-borne pathogens such as Hepatitis B, Hepatitis C, and HIV. Despite advancements in safety protocols and devices, NSIs remain under-reported and inadequately addressed. Objectives: This study aimed to assess the prevalence, contributing factors, and preventive practices related to NSIs across multiple hospitals in India, with the goal of identifying actionable strategies to improve healthcare worker safety. Methods: A cross-sectional descriptive study was conducted across 38 hospitals using structured questionnaires to gather data on NSI frequency, causes, timing, devices involved, preventive practices, and post-exposure protocols. The survey captured with both quantitative and qualitative insights from 44 respondents. Results: The majority of NSIs occurred in wards and emergency departments, with bedside nurses and housekeeping staff being most affected, major causes included needle recapping (68%), improper disposal (62%), and protocol deviations (66%). While awareness programs and post-exposure protocols were in place in many institutions, under-reporting remained a major barrier leading to 50% of staff citing lack of priority and 39% fearing of PEP treatment. Conclusion: The study highlights the urgent need for widespread training, stricter enforcement of safety-engineered devices using in a safe manner, improved reporting systems and institutional culture shifts to report every incident, finally creating a safe environment by minimizing incidents of NSIs and protect front-line healthcare workers.