This study examines the association between nurse staffing ratios and postoperative complications using discharge data from 46 Maryland hospitals. The authors report findings based on categorizing intensive care units (ICUs) into those with less versus greater nurse-to-patient ratios. Results demonstrated an increased risk for complications, including specific respiratory-related ones, in ICUs with smaller care ratios. The authors suggest that nurse staffing affects the quality of postoperative care and that continued efforts should explore optimal care ratios as one method of reducing ICU complication rates.