Currently TCM has basically reached a common view on the pathogenesis mechanism for myelodysplastic syndrome, mainly due to the problems of “spleen and kidney”. Deficiency of spleen and kidney is the fundamental. Etiological factors and pathogenesis is the surface performance. According to the common clinical manifestations，it can be divided into five kinds of syndromes, including the deficiency syndrome of both Qi and blood, deficiency syndrome of both Qi and Yin, syndrome of endogenous heat due to yin deficiency, deficiency syndrome of the Yin and Yang and blood stasis and toxin stasis. TCM can be applied in different stages of diseases, which means to support healthy qi at the early stage of the disease, and to strengthen detoxification and removing stasis later. It has important academic theoretical value and wide prospect of clinical application when giving full play to the advantages and characteristics of Chinese medicine which can improve clinical symptoms, improve life quality, prolong the survival period, slow the speed of leukemic transformation and reduce conversion rate of leukemia according to the chronic pathogenesis of MDS.