Work-related musculoskeletal disorders are prevalent among nurses and other healthcare workers worldwide, and patient-handling tasks are a common precipitating event. Existing research has focused on patient-handling within long-term care facilities and has identified physically demanding patient-handling tasks within this context. It is not known, however, whether nurses in acute care facilities have similar exposures. Using on-site work sampling procedures and a subsequent survey, the primary aim of the present study was to identify, describe, and rank the physically demanding patient-handling tasks performed by nursing staff in an acute care facility. The 10 most physically demanding patient-handling tasks were identified and contrasted with earlier results. Compared to long-term care facilities, in which the majority of tasks have been shown to be associated with performance of activities of daily living, the most frequently observed tasks in the acute care facility were repositioning tasks. Differences in the types of transfers being performed across types of healthcare facilities, as well as across units within acute care facilities, highlight the importance of determining the patient-handling demands and needs that are unique to each type of healthcare facility. Generalizing across facilities or units may lead to incorrect assumptions and conclusions about physical demands being placed on nurses.Knowledge of the most physically demanding tasks can facilitate future intervention efforts to control exposures and injury risks. Differences in physically demanding tasks likely exist between types of healthcare facilities and suggest distinct approaches are needed.