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Objective: Blood transfussion is generally performed to improve oxygen delivery (DO2). Transfusion decision is mostly based on hemoglobin levels, regardless of actual DO2 requirement. As central venous oxygen saturation (ScvO2) may reflect the imbalance between DO2 and consumption (VO2), the aim of this study was to investigate the effect of red blood cell transfusion on ScvO2 levels in major surgery patients. Materials and Methods: The cases in which the clinician decided to perform blood transfusion among the major surgical cases between American Society of Anesthesiologists I and IV, which received central venous catheter insertion and admitted to intensive care unit after surgery, were included in the study. Arterial hemoglobin levels, oxygen saturations, lactate and base excess levels were measured before red blood cell transfusion (pre-T) and 1 hour after transfusion (post-T). Analysis of these variables was performed with using the Wilcoxon test or the Mann-Whitney U test, and p<0.05 was considered significant. Results: Data's which belong to totally 128 red blood cell transfusion performed with 101 patients was included in the study. ScvO2 values significantly increased from 72.25±6.8% to 75.25±7.06% after transfusion (p<0.0001). While significant improvements were observed in arterial base excess values there was no change in lactate values. Conclusion: According to the results, it was observed that red blood cell transfusion performed in major surgery patients provided significant improvements in tissue oxygenation. [ABSTRACT FROM AUTHOR]