ObjectivesHealth workers exposed to ionizing radiation account for  + 50% of workers exposed to man-made radiation in France. Over the last decade, the use of radiation in medicine has increased due to the introduction of new practices. The EXposition des Professionnels de santE aux RayonnemenTs ioniSants study aims to evaluate and characterize the trends in radiation exposure of health workers in France between 2009 and 2019.MethodsThis retrospective study includes all health workers with at least one dosimetric record in the system for occupational dosimetry registration (Système d’information de la surveillance de l’exposition aux rayonnements ionisants) database for each of the years 2009, 2014, and 2019, in the hospitals included in the study. Individual external doses and socio-professional data were collected. Statistical analyses include descriptions, graphs, and logistic regressions.ResultsA total of 1457 workers were included (mean age: 39.8 years, 59% women). The average exposure significantly decreased between 2009 and 2019 (−0.008 mSv/year,p< 0.05). There were large discrepancies in trends according to professions, departments, hospitals, and gender. Over the 10-year study period, radiologic technologists and physicians were the most exposed (0.15 mSv (95%CI 0.14–0.16) and 0.13 mSv (0.06–0.21), respectively), but their exposure tended to decrease. Workers in nuclear medicine departments had the highest radiation exposure (0.36 mSv (0.33–0.39)), which remained stable over time. Thirty-eight percent of recorded doses were nonzero in 2009, decreasing to 20% in 2019.ConclusionsThis study allowed to identify physicians and radiologic technologists in nuclear medicine departments as the most exposed medical workers in France, and to show an overall decrease trend in radiation exposure. This should be instructive for radiation monitoring and safety of exposed medical workers.Key Points• Radiation exposure of healthcare workers in most medical departments has steadily decreased between 2009 and 2019 in several French hospitals.• The number of zero doses consistently increased during the study period.• Workers in nuclear medicine departments are the most exposed, especially radiologic technologists and physicians.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00330-023-09541-z.