Abstract: Objective To analyze the risk factors of allogeneic blood transfusion during meningioma resection. Methods 262 patients with meningiomas in the First People's Hospital of Liangshan Yi Autonomous Prefecture between February 2016 and April 2020 were retrospectively analyzed. The possible risk factors of perioperative blood transfusion were collected. The patients were divided into two groups according to the presence or absence of blood transfusion. The differences of various factors between the two groups were compared, and the influence of each factor on blood transfusion during meningioma resection was analyzed by multivariate logistic regression. Results Among the 262 patients included in this study, 161 （61.45%） received blood transfusion with a blood transfusion volume ranging from 1 to 10 U, （average 4.08±1.21 U）. Based on univariate analysis, multivariate analysis showed that patients with meningiomas were older than 60 years old odds ratio（OR） 1.526, 95% confidence interval（CI）1.214~1.928, tumors located in skull base （OR 1.759, 95%CI 1.311~2.428）, tumor diameter >3 cm （OR 1.642, 95%CI 1.371~2.162）, involvement of important vessels （OR 1.553, 95%CI 1.131~1.920）, operation time >4 h （OR 1.794, 95%CI 1.238~2.562）, preoperative hemoglobin lower than normal （OR 1.930, 95%CI 1.527~2.793） and no preoperative tumor embolization （OR 1.841, 95%CI 1.494~2.605） were risk factors for blood transfusion （P<0.05）. Conclusions The blood transfusion rate during meningioma resection was relatively high, which was mainly affected by the patient's age, tumor location, tumor diameter, important blood vessel involvement, operation time, preoperative hemoglobin level, and preoperative tumor embolization.