This paper outlines the BMT activity in India and describes in some detail the transplant program at the Christian Medical College, Vellore. In September 2005, data from six transplant centers in India were collected and a total of 1540 transplants have been performed in a country of over one billion population. At the center in Vellore, from October 1986 to December 2006, a total of 626 transplants have been performed in 595 patients, with 28 patients having more than one transplant. Thalassemia accounted for a third of these transplants: the country has over 20 million carriers and 10,000 children are born each year with thalassemia major. The average cost of allogeneic BMT in India is around $15,000-20,000, and this is considerably lower than the cost in the West. India needs to develop more transplant centers with adequately trained personnel, as there is great need for them. Improvements in the economy mean that more patients can afford this treatment.