To identify risk factors for blood transfusion during cesarean section in women with major placenta previa. We conducted a retrospective single-center cohort study of 110 women with major placenta previa who underwent cesarean section at the Department of Obstetrics and Gynecology, Karlsruhe Municipal Hospital, between 2014 and 2021. We grouped patients by whether they received a perioperative blood transfusion. Maternal characteristics and clinical factors were compared to identify risk factors. Twenty women (18.2