The liver plays a critical role in numerous functions, including metabolism, detoxification, protein synthesis, and many other important processes. Due to changes in coagulation factors and hematological factors, end-stage liver disease places patients at great risk for bleeding and concomitant thrombosis. Liver transplantation is curative for end-stage liver disease and fulminant hepatic failure. Liver transplantation is associated with significant blood loss and hemodynamic instability; thus, patients must be thoroughly assessed and optimized before transplantation. Intraoperative management focuses on managing blood loss and coagulopathy with blood product transfusion, controlling hemodynamics, and correcting electrolyte abnormalities. There are different techniques and strategies that the surgeon and anesthesiologist can take to minimize blood loss, including utilizing cell saver, allowing a lower central venous pressure (CVP) during dissection, and the use of the piggyback surgical technique. During the postoperative period, recipients are at risk for cardiopulmonary complications, bleeding, thrombosis, and graft failure. Improvements in immunosuppressive regimens have improved postoperative transplant outcomes.