Background: Peri-operative morbidity and mortality varies considerably among hospitals. Given the highly complex surgery required for urologic cancer, post-operative adverse event management may be superior if treated in the same institution as the index surgery. Methods: We accessed the Washington State Comprehensive Hospital Abstract Reporting System from 2009-2013 to identified patients who underwent radical nephrectomy (RN), partial nephrectomy (PN), radical cystectomy (RC) or retroperitoneal lymph node dissection (RPLND) for malignant disease. Mortality rates were assessed in those with an adverse outcome requiring hospital re-admission within 90 days of surgery. The primary hospital (PH) was the institution where the main surgery took place. Secondary hospitals (SH) were all other hospitals. Relationships with mortality were examined using multi-variate modeling. Results: 4,542 patients were identified who underwent major urologic cancer surgery, of which 56% were RN, 26% PN, 15% RC and 2% RPLND. Overall, 795 (18%) experienced an adverse event following surgery requiring hospital admission. 64% of patients returned to their PH for management, but was dependent on the surgery performed (60% RN, 65% PN, 67% RC and 83% RPLND). When stratified by hospital volume, patients were more likely to present to their PH (p=0.0005), with more patients returning to their PH if it was a low vs. high volume center (72% vs 55%). Comorbidities and length of stay on index surgical admission did not affect whether patients chose to present to their PH or a SH for adverse event management. The overall mortality rate was 5%. On multi-variate analysis, patients who underwent surgery at a high-volume PH and presented to a SH for adverse event management had higher rates of mortality (p=0.03). Conclusions: Adverse events within 90 days of surgery of major urologic cancer surgery are associated with a low mortality rate, and most patients present to their PH for management. However, patients presenting to a SH experienced a higher mortality rate following an adverse event. These findings require further investigation and may aid in future quality improvement initiatives to reduce the morbidity associated with these complex surgeries.