OBJECTIVES: Needlestick injuries (NSIs) represent a significant clinical and economic burden to healthcare systems and society.  The EU Directive on the prevention of sharps injuries recommends adherence to a range of safety measures, of which providing safety-engineered devices (SEDs) forms a key part.  An economic model was constructed to investigate the potential hospital budget savings associated with the use of SEDs rather than conventional (i.e. non-safety-engineered) devices when conducting procedures with sharp devices. METHODS: An incidence-based, deterministic budget impact model with a five-year time horizon was developed from the perspective of a Belgian hospital.  Costs are discounted at 3%, in line with Belgian guidelines for pharmacoeconomic evaluation.  The model takes into account device acquisition costs and other direct and indirect costs associated with NSIs occurring from infusion, injection, blood collection and insulin administration for diabetes care.  Model input data were derived from the Institut National d'Assurance Maladie-Invalidité (INAMI), published studies, clinical guidelines, and market research. RESULTS: For a 420 bed hospital, an estimated 384,720 sharps procedures occur annually.  Over five years, the total cost of conducting these procedures using conventional devices was estimated to be €580,700, of which €326,700 or 56% was spent managing 310 NSIs.  If all procedures were instead conducted using SEDs, the model estimates that the number of NSIs would be reduced to 75.  Total costs with SEDs are estimated to be €528,500, representing an overall cost saving of €52,200 or 9%.  Greater acquisition costs for SEDs are offset by a decline in NSI management costs. CONCLUSIONS: Costs associated with NSIs are a significant avoidable cost of conducting sharps procedures. SEDs may reduce the economic burden of managing NSIs, which may partially or completely offset any increase in device acquisition costs.