Background: Blood transfusions, crucial for emergency obstetric care, can significantly reduce maternal mortality rates. Obstetric transfusions are often urgent and unpredictable. Common emergencies include hemorrhages from ectopic pregnancy, abortions, and placenta previa. Transfusion rates vary globally, with 0.2%-3.2% in high-resource countries and higher in low-resource areas. Despite their benefits, transfusions carry risks such as allergic reactions and infection transmission. Aim of the study: The study aims to ascertain the indications and risk factors associated with blood transfusions in obstetric and gynecological patients. Methods: This retrospective observational study at the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, analyzed indications and risk factors for blood transfusions in obstetrics and gynecology patients over one year. It included 115 women, with 110 obstetrics and 5 gynecology patients. Inclusion criteria covered women undergoing cesarean sections, vaginal deliveries, or other gynecological treatments and those with obstetric complications like postpartum hemorrhage. Exclusion criteria included women needing transfusions after seven days postpartum or with congenital bleeding disorders. Result: The majority of participants (66.96%) were aged 21-30, with 85.22% from low socioeconomic backgrounds. The mean BMI was 22.55±4.07. Most women (69.57%) were in the 31-40 weeks gestational age range. Multigravida and primigravida were 51.30% and 44.35%, respectively. Over half (57.6%) were not booked for antenatal care. Cesarean sections were the most common delivery method (60.87%). Vaginal delivery was the most frequent intervention (33.91%). Blood transfusion was mainly due to postpartum anemia (39.13%). Packed cell volume was the most transfused product (62.28%). Most (94.78%) had no transfusion reactions, with urticarial rash in 2.61% of cases. Conclusion: The study found that blood transfusions in obstetrics and gynecology are mainly due to severe anemia, postpartum hemorrhage, and complications like placenta previa and DIC. Most transfusions occurred in women aged 21-30, primarily multigravida and unbooked patients, indicating a need for better antenatal care. Packed cell volume was the most common blood product used.