Background: Blood transfusions are frequently required for critically ill patients with gastrointestinal surgery to correct anemia or because of excessive blood loss from associated trauma or operative procedures. Ensuring the safety of blood transfusion procedure is the role of nurses in the intensive care unit (ICUs). Aim: The current study aimed to investigate critical care nurses' compliance with blood transfusion guidelines in Gastrointestinal ICUs. Method: A descriptive observational research design was used to conduct this study with a convenience sample of 49 nurses working in three ICUs affiliated with a university hospital in Egypt. One tool was used to collect data for this study: Critical care nurses' compliance with blood transfusion practice. Results: Most of the participant nurses (81.6%) had satisfactory practice level regarding their compliance with blood transfusion guidelines with a total mean practice score of 86.5±2.1. Conclusion and Recommendations: The study highlights the need for organizing a refresher training program regarding the checking of blood requests and documentation of blood transfusion. This will improve nurses' practice, optimize patient safety and prevent complications of the transfusion process.