This chapter details the safety aspects of needles and syringes–medical devices used for injecting medications into the human body and withdrawing fluid from the body. Although the chapter focuses on developing countries, many aspects also apply to industrialized countries. The majority of injection devices are now produced for single use. Safety problems associated with the use of needles and syringes include infections caused by the reuse of contaminated devices and accidental pricks by needles (needle sticks). Pricks by contaminated needles also lead to infections. The serious impact of injection safety in global health has led to an active group called the Safe Injection Global Network (SIGN, www.injectionsafety.org) and a SIGN Internet forum (e-mail:sign@uq.net.au). This chapter describes technical reasons not to reuse devices, auto-disable syringes to prevent reuse, safety boxes to contain sharps immediately after use, and the ultimate disposal of used sharps. The life cycle management concept proposed for major medical equipment is applied to injection devices to ensure safety in health program planning and delivery. (See Chapter 31.)