Intra-operative systems for identifying surgical sharp objects are provided. Aspects of the systems include an intra-operative imaging device for obtaining intra-operative surgical sharp object image data; and a surgical sharp object automated shape recognition module configured to identify a surgical sharp object from intra-operative surgical sharp object image data. Systems of the invention may further include additional components, such as surgical instrument and/or sponge identification and tracking devices. Systems of the invention find use in a variety of methods and applications, including tracking of surgical items during a surgical procedure.