Background: Hypercoagulability in patients with cancer is difficult to detect through standard coagulation tests unless the platelet count and fibrinogen concentration is markedly increased. Reaching haemostasis during major surgical procedures is one of the most difficult problems which face anaesthesiologists. Objective: The aim of this study is to investigate the impact of desflurane in comparison to sevoflurane on coagulation detected by ROTEM to find out which of them is more suitable in reducing blood loss and better patient outcome after major surgery in the study population of patients. Patients and Methods: This study was conducted on thirty-six patients of both sexes having cancer bladder were admitted to Theodore Bilharz Research Institute (TBRI). They were randomly allocated into 2 groups (18 patients each). Group (S) received sevoflurane, while group (D) received desflurane as an inhalational anesthetic for Radical Cystectomy surgery. Six venous blood samples were collected for assessment of thromboelastometric parameters with INTEM, EXTEM, FIBTEM analysis which were CT (clotting time), CFT (clot formation time), α angle and MCF (maximum clot firmness).