Introduction: Healthcare workers (HCWs) are exposed to different health hazards as a part of occupational risk including needlestick and sharps injuries (NS&SIs). Organizational safety climate is considered an important factor in prevention of those injuries Aim of work: to assess the prevalence and risk factors of needle sticks and sharps injuries among HCWs in an Egyptian Governorate hospitals (Menoufia Governorate) and evaluate the organizational safety climate. Materials and methods: An analytical cross sectional study was conducted during the period from May 2018 to May 2019, on 350 HCWs from tertiary and secondary care hospitals in Menoufia Governorate. HCWs were subjected to a predesigned questionnaire about occurrence of NS&SIs and suspected risk factors, and organizational safety climate scale questionnaire. Results: Prevalence of needlesticks and sharps injury in the last year was 64%; of which more than 65% had ≥2 injuries. Risk factors of NS&SIs included being younger age, male sex, working at surgical departments, less work experience, having night shifts, longer working hours/week, using of needles and sharps daily, wearing personal protective equipment and needle recapping. Using syringes daily, surgical specialty, wearing personal protective equipment (PPE) and recapping needles were independent predictors for occurrence of NS&SIs (OR= 7.03, 6.27, 2.67 and 2.31; respectively). The best factors attributing to organizational safety climate were the readily accessible sharps containers 81.1% and open communication between staff nurses and supervisors 78.9%. Conclusion: The risk of NS&SIs is still high among HCWs that underlines the emphasis on enhancing the organizational safety climate to decrease the risk of job-related injuries with all its consequences.