The koala (Phascolarctos cinereus) population in Australia has been subjected to numerous threats leading to a significant decline in their numbers. The Port Macquarie region serves as a vital habitat for these iconic marsupials. Analysing records of 1227 koalas admitted to the Port Macquarie Koala Hospital (2014–2022), this study aimed to understand admission causes, temporal trends, and risk factors. Anthropogenic activities accounted for almost half (49.7%) of all admissions with ‘dangerous area’ and ‘motor vehicle accident’ (MVA) being common aetiologies. Young koalas were more susceptible to ‘dangerous area’, ‘MVA’, and ‘dog attack’ than other age groups. Koalas admitted for suspected chlamydia were also a significant contributing factor for admissions, and was most common in young koalas. Overall, the majority of koalas were candidates for rehabilitation or release (54.3%), but mature and aged koalas had the highest odds for mortality. This study highlights the ongoing impact of anthropogenic activities on koalas, emphasises the need for public education and reporting to mitigate risks, and underscores the importance of addressing diseases like chlamydia. These results contribute to our understanding of the factors influencing koala hospital admissions and can inform conservation and management strategies for this iconic Australian species.