INTRODUCTION AND OBJECTIVE: Rezum is a minimally invasive technique to treat benign prostatic hyperplasia (BPH). Major advantages include no de novo erectile dysfunction and low rate of retrograde ejaculation. Discontinuation of peri-operative antiplatelet and/or anticoagulation (APAC) is often preferred in practice to avoid bleeding complications. The objective of this study is to examine outcomes and complications in patients undergoing Rezum on APAC. METHODS: We retrospectively reviewed patients who underwent Rezum therapy at our institution since 7/2017. When deemed medically necessary, APAC was continued in the perioperative setting. Post-procedure catheterization regimen included a minimum of 3 days and a maximum of 4 weeks in men with preoperative catheter dependence. Outcomes included pre- and post-operative AUA symptoms score, peak flow, and postvoid residual. Bleeding-related complications and urinary tract infection rate were recorded. RESULTS: Of 214 patients who underwent Rezum therapy, 68 patients were treated on APAC. The average prostate gland size was 73 grams. Significant improvements were seen in AUA symptom score, peak flow, and post void residual (Table 1). Bleeding complications requiring intervention occurred in 6 (9.3%) patients, with all 6 undergoing catheter irrigation, 2 undergoing blood transfusion, and 1 undergoing cystoscopic clot evacuation. Interestingly, 9/146 (6.3%) patients who were not on APAC had hematuria requiring intervention. There were no statistically significant differences in bleeding complications. There was no de novo erectile dyfunction reported. CONCLUSIONS: In our experience, bleeding complications in patients undergoing Rezum on APAC is uncommon. There were no apparent differences in complication rates between patients on APAC and those not on APAC. To the best of our knowledge, this is the largest study to examine outcomes and complications of Rezum in patients on APAC. Rezum appears to be a safe and efficacious treatment option in men continuing APAC who wish to preserve sexual function. (Figure Presented).