Background: Given the lack of evidence on hand hygiene (HH) compliance among hospital visitors, this study evaluated HH compliance among caregivers of hospitalized patients in three liver transplantation wards with a high healthcare-associated infection risk. Methods: At a 2,743-bed Korean tertiary-care hospital, four infection control nurses took turns covertly observing HH compliance across three wards for liver transplantation during weekdays at lunch-time, from January 3 to January 28, 2022. The observation tool was adapted from the World Health Organization (WHO) checklist and a form previously modified by prior research on visitors. The collected data were analyzed using the χ 2 test or Fisher’s exact test. Results: The average HH compliance rate was 13.0% for 663 hand hygiene opportunities among 454 caregivers. The adult group showed a higher HH rate (16.0%) than the elderly group (8.4%; P=0.004). The private caregiver group had a lower HH rate (9.9%) than the family member group (13.3%; P=0.404). The most frequently observed moment (56.1%) was “after touching patient surroundings” largely due to curtain contact (53.7%). Although “after touching a patient” was the least frequent (2.9%), it showed the highest compliance rate (36.8%). Notably, the HH rates for “before touching a patient” (14.3%) and “before clean/aseptic procedure” (6.2%) were lower. Conclusion: Our results highlight the importance of infection control education, especially HH education for caregivers of hospitalized patients.