This is a case presentation of an accidental contaminated needle stick injury from a patient known to be infected with both Human Immunodeficiency Virus (HIV) and hepatitis B. The patient was managed with prophylactic hepatitis B immune globulin, hepatitis B vaccination and the HIV retroviral drug zidovudine (AZT). At one year after treatment the patient was not infected with HIV or hepatitis B, and there was adequate immunity generated after vaccination for hepatitis B.