Background <p>HBV is the primary blood-borne pathogen of occupational exposure among healthcare workers (HCWs) in China. This study aims to analyze the characteristics of occupational exposure to HBV, and the ultimate goal is to optimize post-exposure management strategies for medical personnel.</p> Methods <p>Data of serum HBV markers (HBV-M) from a routine physical examination of HCWs in 2022 were retrieved, and characteristics of HBV-M were analyzed. Registration information of HBV occupational exposure from 2018 to 2022 was collected, and related risk factors were analyzed. HCWs injected with hepatitis B immunoglobulin (HBIG) were followed up.</p> Results <p>4,419 HCWs underwent physical examination, and there were nine patterns of HBV-M identified. HBsAg positive rate was 1.54%, and anti-HBs positive rate was 65.6%. There were 161 HBV occupational exposure incidents with no cases of HBV infection. Among categories of related factors for occupational exposure, occupation as a nurse, work experience &lt; 5 years, sharp instruments as disposable needles, places of exposure as general wards, and operational processes as during surgical procedures were risk factors accounting for the highest proportion, respectively. 36 individuals received HBIG injection after exposure. One month after HBIG injection, the anti-HBs non-responder group at baseline showed low anti-HBs titers, which turned negative three months later.</p> Conclusions <p>HBsAg positive rate is relatively low among HCWs, while anti-HBs positive rate is slightly higher than that of the general population. The management and control of major exposure factors should be strengthened. One month after HBIG injection might be the optimal timing for catch-up vaccination of hepatitis B vaccine.</p> Clinical trial registration <p>This study does not involve any clinical trials. Clinical trial number is not applicable.</p>