Objective — to investigate the structure and frequency of early 30-day complications from radical cystectomy (RCE) and to determine the most significant predictors affecting their development. Subject and methods. RCE was performed in 182 patients (152 (83.5%) men and 30 (16.5%) women, their age was 31 to 84 years (mean age, 62.3±0.735 years). The indications for surgery were bladder cancer (n=169 (92.9%), other pelvic tumors (n=9 (4.9%), and microcystis (n=4 (2.2%). Orthotopic bladder reconstruction was carried out in 138 (75.8%) patients. For microbiological monitoring, a microbiological study of preoperative urine and peritoneal lavage fluid was conducted. Postoperative complications were assessed using the Clavien—Dindo system. Calculations were made employing the Statistical Package for the Social Sciences ((SPSS) Statistics 16. Results. Bacteriological monitoring demonstrated that the patients undergoing RCE had a high frequency of preoperative urine and peritoneal lavage fluid infections (41.8 and 54.4%, respectively). Thirty-day complications were recorded in 98 (53.8%) patients. Mild (Clavien—Dindo I—II) and severe (Clavien-Dindo III—V) complications were most common (these were 72.3 and 27.6%, respectively). The structure of complications was marked by a preponderance of gastrointestinal (26.9%) and infectious (25.8%) ones. The significant predictors influencing the incidence of complications were low body mass index (p=0.008), preoperative anemia (Hb less than 90 g/l) (p=0.034), blood loss (more than 600 ml) (p=0.003), and abdominal infection (p<0.001). The predictors affecting the development of severe categories of complications according to Clavien-Dindo grade III—V were preoperative hemoglobin levels (less than 90 g/l) (p=0.021), intraoperative blood loss (more than 600 ml) (p=0.019), and intra-abdominal infection titers (p=0.007). In the carbapenem group, the incidence of complications was almost 2 times lower (p=0.043), while complications of the more severe category developed 3 times less frequently (OR=0.306) than in the other groups. Conclusion. RCE is associated with a high risk for early postoperative complications; gastrointestinal and infectious complications are most common. Intraoperative abdominal infection was a significant predictor for their development. It is necessary to continue studying the etiology and pathogenesis of complications from RCE.