Over eighty years have passed since Donath and Landsteiner identified the syndrome of PCH and reported an in vitro test for its diagnosis. The accuracy of their observations, and the usefulness of the DL procedure has persisted. PCH has been investigated over the years providing further information regarding antibody specificity and serological characteristics. However, the etiology of the syndrome remains to be elucidated. PCH, which was once thought to be rare and associated primarily with congenital syphilis, is not encountered as one of the most common causes of acute transient hemolytic anemia in young children.