Pre-operative discontinuation of novel oral anticoagulants (NOACs) in cardiovascular surgery (CVS) is necessary to reduce peri-operative bleeding risks. However, there is little data on optimal pre-operative hold times for these agents and their effect on the length of stay (LOS). A retrospective evaluation of the effect of pre-operative NOAC hold times (i.e. ≤2 or ≥3 days) with or without heparin bridging, on LOS (i.e. hospital and ICU). Baseline and follow-up clinical data were collected for consecutive CVS patients treated with NOACs at a single tertiary care centre (2013-2016). After calculations of bivariate associations and between-group differences, multivariate linear regression was used to evaluate the association between NOAC hold times and post-operative complications and LOS. In 107 patients (age= 73.6±7.7 years, 72.9% male, 83.2% Atrial Fibrillation history), NOACs hold times ranged from: ≤2 days (Group 1, n= 17), ≥ 3 days without heparin (Group 2, n= 63), and ≥3 days with heparin (Group 3, n= 27). Mean LOS were respectively 20.0 (25.8), 7.6 (4.12), and 13.6 (8.21) days post-operation (Group 1- Group 2= 12.4 days; p= 0.001). In contrast, length of ICU stays did not differ between groups (3.6, 1.9, 3.1 days in groups 1-3 respectively, p= 0.17). Aside from significantly higher LOS among patients with major bleeding (15.3 vs. 8.2 days, p= 0.01) or a bleeding episode (18.1 vs. 8.3 days, p= 0.01), there were no significant differences in LOS according to baseline comorbidities or other CVS complications. Multivariate linear regression model, adjusted for age, sex, NOACs and procedure type (elective versus emergent), indicated significantly shorter LOS when NOACs were held ≥3 days without heparin (Group 2) compared to ≤2 days pre-op (Group 2: b= -11.70 [-17.94, -5.46], p< 0.001, Adj. R2= 0.19). Despite trending towards lower LOS, group 3 (i.e. ≥3 days with heparin) was not associated with significantly lower LOS (Group 3: b= -5.24 [-12.09, 1.61], p= 0.13). These findings persisted even after additional adjustment for major bleeding (Group 2: b= -10.46 [-16.62, -4.31], p= 0.001, Adj. R2= 0.23) or postoperative bleeding episode (Group 2: b= -9.30 [-15.45, -3.15], p= 0.003, Adj. R2= 0.26). Compared to NOACs held ≤2 days before CVS, holding NOACs for ≥3 days before CVS without heparin bridging was independently associated with shorter LOS, even after adjustment for differences in major bleeding.