Bone marrow transplantation is the only curative treatment in adult patients with AML who fail to attain a complete remission or who experience a relapse. Unfortunately, the median age for patients with AML is estimated to be 62 years, which precludes allogeneic BMT for a significant number of patients with AML. For patients with relapsed AML who lack an HLA-identical donor or who are too old to undergo allogeneic BMT, autologous BMT should be considered since current standard salvage chemotherapy regimens do not produce durable remissions in the overwhelming majority of patients. The role of allogeneic and autologous BMT was initial postremission therapy is controversial. Ongoing studies may define the optimal postremission therapy for adult patients with AML in first remission.