Purpose: Despite the major improvements in surgical technique and peri-operative care, radical cystectomy (RC) remains a major operative procedure with significant morbidity and mortality. Emerging evidence has shown a direct relationship between surgeon and hospital volumes and morbidity for major surgeries such as radical cystectomy, suggesting a movement towards centralization of major surgeries. We aim to evaluate the current standard for open radical cystectomy (ORC) by comparing outcomes from a moderate to high-volume center that performs at least 10 ORC annually to other higher volume centers (≥20 ORC/year). Methodology: Patients undergoing Radical Cystectomy (RC) between 2019 and 2022 were identified. Perioperative outcomes and complication rates that were categorised according to the Clavien-Dindo classification. Data obtain was compared to existing data published from other tertiary centres in Australia and United Kingdom. Results: 30-day and 90-day mortality rates were 1.85%, aligning closely with rates from New South Wales (1.8% and 3.6%) and the UK (1.58% and 2.72%). Clavien-Dindo grade I/II complication rates were lower than the UK (48.1% vs. 60.9%), and grade III+ complications were markedly reduced (14.8% vs. 31.4%). Overall post-operative complication and mortality in this study were similar when compared to outcomes from other high-volume centers. Conclusions: Morbidity and mortality remain high following radical cystectomy. Centralisation of RC to high-volume centres is recommended, in line with current guidelines. We suggest that a high-volume centre in Australia should be defined as a hospital that performs >10 RC/year to better aid the process of centralisation of RCs locally.