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Objective: To explore the expression patte of PACAP gene in patients with myelodysplastic syndrome (MDS). Methods: The expression pattem of PACAP gene in CD34+ cells from MDS patients was determined by microarray, con-firmed in expanding samples by quantitative real-time PCR in bone marrow mononuclear cells. Results: The transcription of PACAP gene was found significantly down-regulated in patients with MDS in comparison with that in control samples, with a means of 220.1 in MDS-RA and 116.8 in MDS-RAEB (P < 0.05 ). Conclusion: PACAP gene is expressed significantly lower in patients with MDS.