Charge transport and Random Telegraph Noise (RTN) are measured successfully at the nanoscale on a thin polycrystalline HfO2 film using room temperature Scanning Tunneling Microscopy (STM). STM is used to scan the surface of the sample with the aim of identifying grains and grain boundaries, which show different charge transport characteristics. The defects responsible for charge transport in grains and grain boundaries are identified as positively charged oxygen vacancies by matching the localized I-V curves measured at the nanoscale with the predictions of physics-based multi-scale simulations. The estimated defect densities at grains and grain boundaries agree with earlier reports in the literature. Furthermore, the current-time traces acquired by STM at fixed bias voltages on grains show characteristic RTN fluctuations. The high spatial resolution of the STM-based RTN measurement allows us to detect fluctuations related to individual defects that typically cannot be resolved by the conventional device-level probe station measurement. The same physical framework employed to reproduce the I-V conduction characteristics at the grains also successfully simulates the RTN detected at the nanoscale. We confirm that charge trapping at defects not directly involved in charge transport can induce significant current fluctuations through Coulombic interactions with other defects in the proximity that support charge transport. © 2017 Author(s).