A retrospective study of two cohorts of patients who underwent radical cystectomy for bladder cancer has shown that intraoperative blood transfusion is associated with poorer outcomes than perioperative transfusion. Patients who received intraoperative transfusions were less likely survive for 5 years after surgery than those who received perioperative transfusions. 5-year recurrence-free survival was also lower for these patients. These results underline that the timing of transfusion can influence patient outcomes, as has been shown in other malignancies.