Introduction: Cesarean section is one of the most common surgical procedures that is performed when certain complications occur during pregnancy or childbirth. It is associated with a risk of excessive blood loss and possible transfusion therapy. This research paper analyzes the red blood cell transfusion during delivery by caesarean section and compares it with regard to the type of cesarean section (elective and emergent), maternal age, gestational age, number of previous births, preoperative hemoglobin concentration and the frequency of ABO and Rh blood groups. Methods: This retrospective study of the transfusion treatment of pregnant women who gave birth by caesarean section was conducted at the Čakovec County Hospital from January 1, 2022 to December 31, 2023. In the research 478 woman were included. An analysis of the statistical significance of the relationship between the monitored variables was carried out. Results: During the followed up period, 25.59% women were delivered by caesarean section. By emergency caesarean section 285 (59.60%) women gave birth and slightly less, 193 (40.40%), by elective. The frequency of cesarean delivery was highest among nulliparous women aged 30 to 35, among whom significantly more had emergency cesarean section compared to multiparous women (P < 0.001). Fifty four (11.30%) women received a blood transfusion within 48 hours of delivery, an average of two red blood cell units. The frequency of blood transfusions was significantly influenced by several factors. One of them is the maternal age, and the majority of transfused women were between 30 and 35 years old. Lower preoperative hemoglobin concentration is significantly associated with an increased risk of transfusion therapy as well as the number of previous birth. Significantly more nulliparous women received blood transfusions compared to multiparous women (P=0.0033). The distribution of ABO and Rh blood groups was consistent with the distribution in the Croatian population, regardless of transfusion treatment, except for a higher proportion of RhD-negative mothers in the group of transfused women. Conclusion: This research confirms that caesarean section, emergency or elective, poses a risk of excessive blood loss, especially in nulliparous women, women between the ages of 30 and 35, as well as women in labor with decereased preoperative hemoglobin concentratione. The importance of transfusion treatment with a selected blood product was highlighted by an insight into the critical points of blood products use in the delivery by cesarean section. This reduces comorbidity and the incidence of complications, improves the quality of treatment and the satisfaction of women, which ultimately has a positive effect on the health system.