Objectives: This cross-sectional study sought to determine the prevalence rate of sharps including needlestick injuries (NSI) in a 12-month period among nurses and midwives, factors associated with NSI injuries and to compare data across workplace categories and geographic regions. Methods: The study surveyed a randomly selected representative sample of nurses (n = 7423) from the NSW Nurses’ Association membership representing members from five major workplace categories and four major geographic regions. Results: A total of 1301 eligible contactable nurses participated (response rate 18.5%). The 12-month self-reported prevalence rate of injury was 6.5% (n = 84). NSI rates of injury were higher in the clinical areas of emergency room, operating theatres, medical and surgical wards, mental health and aged care. By geographic region the rate of injury was highest in remote areas (16.4%). Logistic regression modelling was used to identify factors which increase the risk of a NSI injury; only working in a remote region was statistically significant. The odds of sustaining a NSI injury for nurses and midwives working in remote areas was 2.9 times the odds for nurses working in city/inner regional areas when controlling for other risk factors. Conclusions: The NSI rates of injury reported in this study are similar to those reported in other recent state and national studies in Australia and the UK. No significant differences were identified when clinical areas were compared. This study suggests that the risk is significantly higher in remote areas.