Magister Public Health - MPH / Introduction: The Universal Safety Precautions (USP) are a set of principles including practices and protocols, which is meant to reduce or prevent occupational exposures to blood borne pathogens among health care workers (HCWs), during the course of their duties in health care settings. Globally and in Nigeria, significant number of HCWs are currently being exposed to blood and other body fluids while working in the hospital setting (Amoran, 2013; Samuel et al., 2008; Akinboro et al., 2012; Ajibola et al., 1994; Okechukwu et al., 2012). These exposures contribute annually to about 16,000 HCV infections and 66,000 HBV infections among HCWs worldwide (Prüss-Üstün et al., 2003) and about 1000 cases of HIV per annum in Nigeria since the first recorded case in 1984 (Okechukwu et al., 2012; Patricia et al., 2007). The objectives of the study were to describe the awareness of the USP among HCWs in Kogi State Specialist Hospital (KSSH), Lokoja and to describe the adherence to the USP among HCWs at KSSH. Methods: A descriptive cross-sectional study was conducted among HCWs working in departments where contacts with patients' blood and other body fluids are possible in KSSH. An anonymous self-administered questionnaire was used for data collection. Analysis of the data collected was with Software Package for Social Sciences (SPSS) V23.0.0 for Mac. Results: Of the 125 participants that returned their questionnaires, 37.6% were nurses, 17.6% were doctors and the remainder were laboratory staff, dentists and hospital attendants. Sixty four percent (64%) of them were females, 49.6% had tertiary education while their average age was 38.5 years. Awareness of and adherence to the USP were observed to be 5.6% and 2.4% respectively. Statistically, complete awareness of the USP was not significantly associated with complete adherence to the USP. More so, 3% and 2.2% of the participants with the number of years in services within the ranges of 5-9 years and 1-4 years respectively had complete adherence to the USP. Statistically significant association was only noted between participants' age and complete adherence to the USP. Post-exposure prophylaxis (PEP) and use of personal protective equipment (PPE) were the two USP principles with the lowest levels of awareness and adherence, with 46% and 47.6% on awareness respectively and, 43.8% and 44.6% on adherence respectively. Conclusion: The levels of awareness of and adherence to the USP among the HCWs in KSSH were observed to be very low. There is an urgent need for capacity building of the HCWs on the USP in the form of trainings, and in the long term, there is need to conduct a study to assess possible reasons for the observed outcome.