© 2021 Faculty of Anaesthesia, Pain and Intensive Care, AFMS. All rights reserved.Background: To identify determinants of postoperative intensive care unit (ICU) requirement of patients after robot-assisted radical cystectomy (RARC), as RARC is increasingly used for the treatment of recurrent high-grade or locally advanced bladder cancer. Methodology: In this retrospective real-world study, data of 74 patients who had RARC between 2015 and 2017 for the definitive treatment of bladder cancer were examined to identify perioperative factors predicting ICU admission. Patients were grouped as those postoperatively admitted to intensive care unit (ICU group) and those taken to regular urology ward (non-ICU group). Their demographic and perioperative data, Charlson Comorbidity Index, treatments, and laboratory results were recorded. Independent samples t test, Mann-Whitney U test, multivariate logistic regression analysis were used for data analysis. Results: Twenty-nine patients (39.2%) were postoperatively admitted to ICU while the remaining patients were followed in regular ward. Preoperative American Society of Anesthesiologists (ASA) class and estimated blood loss were significantly higher in the ICU group (p < 0.05). Conclusion: Higher ASA classification was found to be predictive for ICU admission following RARC. Prospective randomized trials are required for validation of possible risk factors.