Objective To explore the risk factors of intraoperative blood transfusion in patients with renal transplantation. Methods A total of 405 patients who underwent renal transplantation from January 2017 to June 2021 were enrolled. According to their treatment of intraoperative blood infusion, they were divided into two groups: a blood transfusion group (n=36) and a non‑blood transfusion group (n=369). Both groups were compared for baseline information before surgery, preoperative examination results and intraoperative data. The independent risk factors of intraoperative blood transfusion were analyzed by multivariate Logistic regression. Furthermore, a risk prediction model was established and the discriminative ability of the model was evaluated by the area under curve (AUC) of receiver operating characteristic (ROC) based on the predicted probability value of the model. Results The blood transfusion rate of 405 patients was 8.9%. Compared with the non‑blood transfusion group, the blood transfusion group presented increases in the percent of female, anemia and hypocalcemia (P<0.05), decreases in the percent of smoking (P<0.05), decreases in pre‑operative hemoglobin(Hb), hematocrit (Hct), Ca2+ and albumin (P<0.05), and increases in pre‑operative aspartate aminotransferase (AST) and alanine aminotransferase (ALT) (P<0.05). Compared with the non‑transfusion group, the blood infusion group presented extended anesthesia and operation time (P<0.05), and increases in total albumin, total fluid infusion volume, blood transfusion volume, blood loss and urine volume (P<0.05). Multivariate Logistic regression analysis showed that anemia ［odds ratio (OR)=6.43, P=0.001］, hypocalcemia (OR=2.52, P=0.030), high blood loss (OR=1.01, P<0.001), female (OR=3.46, P=0.004) and long operation time (OR=1.01, P=0.022) were the independent risk factors of blood transfusion. The AUC value, sensitivity and specificity of the combined predictors were 0.856, 0.750 and 0.875 respectively. Conclusions Anemia, hypocalcemia, high blood loss, female and long operation time are the independent risk factors of blood transfusion during renal transplantation.