Myelodysplasia is being increasingly recognized as an important disease not only in the elderly but also in younger patients. It is also being seen more commonly as a complication of treatment with chemotherapeutic agents. Recent advances have distinguished between the different forms of therapy-related myelodysplasia as well as their genetic associations. Although allogeneic bone marrow transplantation using either related or unrelated donors offers the only chance for cure of this disease, cell biology studies also indicate that there is a normal stem cell compartment in the bone marrow of patients with myelodysplasia. Future studies may offer the opportunity for autologous stem cell transplantation for patients achieving remission after induction chemotherapy.