To evaluate the incidence of in-hospital bleeding events, and their impact on length of stay (LOS) and critical care utilization, among patients undergoing cancer-directed surgeries in English inpatient hospitals. We conducted a retrospective, observational cohort study using hospital discharge data from English hospitals (Hospital Episode Statistics [HES] database) linked to electronic health records (Clinical Practice Research Datalink [CPRD]). We selected patients aged ≥18 years who underwent one of the following cancer-directed surgeries with a primary diagnosis of cancer between January 2010 and February 2016: hysterectomy, low anterior resection (LAR, rectal), lung (transplant & resection), mastectomy, and prostate (prostatectomy & resection). The primary independent variable was occurrence of in-hospital bleeding events. The primary outcomes were post-procedure LOS and critical care utilization (both in days). We carried out multivariable regression models to compare the study outcomes between patients with vs. without bleeding events, adjusting for patient’s baseline demographic and clinical characteristics measured from the CPRD for the year prior to hospital admission. The study included 26,438 cancer-directed surgeries (hysterectomy: 6,092; LAR: 2,957; lung: 1,539; mastectomy: 12,806; prostate: 3,044). Incidence proportions of in-hospital bleeding events varied by surgical site (hysterectomy: 1.9%; LAR: 2.9%; lung: 1.8%; mastectomy: 1.5%; prostate: 1.0%). In the multivariable analyses, patients with bleeding events had longer post-procedure LOS (hysterectomy: 8.0d vs. 4.7d, p<0.0001; LAR: 17.8d vs. 12.1d, p<0.0001; lung: 12.0d vs. 8.6d, p=0.002; mastectomy: 5.3d vs. 2.2d, p<0.0001; prostate: 8.7d vs. 3.6d, p<0.0001) and spent more days in critical care (hysterectomy: 6.9d vs. 0.4d; p<0.0001; LAR: 4.1d vs. 1.5d; p<0.0001; lung: 5.2d vs. 2.0d; p=0.001; mastectomy: 0.5d vs. 0.1d; p=0.02; prostate: 1.5d vs. 0.1d; p=0.03) as compared with patients without bleeding events. Among patients undergoing cancer-directed surgeries in English inpatient hospitals, in-hospital bleeding events were associated with a large inpatient healthcare utilization burden.