More than 108,000 patients went without a hospital bed in 2018 - a 9% increase on the previous year.
Figures from the Irish Nurses and Midwives Organisation show the highest trolley figures were reached in the first three months of last year
University Hospital in Limerick is the worst hit followed by Cork and Galway.
INMO General Secretary Phil Ní Sheaghda says there needs to be greater focus on dealing with the crisis.
She said: "As predicted the trolley count for 2018 exceeded all records.
"Hospitals outside of Dublin, particularly Limerick, Cork, Galway and Tullamore were particularly affected and recorded figures that in Limerick alone exceed 11,000 for the year, Cork at 9,000 and Galway over 7,000."
She continued: "All of the research internationally tells us that patients who spend time on trolleys have poorer outcomes to their health.
"In other words, you come into a hospital, you're sick and are deemed sick enough to be deemed requiring admission for further care and your outcome is compromised because the hospital doesn't have proper facilities for you.
"That's simply not good enough in today's day and age."
The worst-hit hospitals included:
Smaller hospitals also saw record overcrowding. South Tipp General Hospital, for example, had 5,201 patients on trolleys this year.