Severe aplastic anaemia (SAA) state of art is summarised. Currently there are two therapeutic possibilities: allogeneic bone marrow transplantation (BMT) and immunosuppressive therapy. Decision should be based on disease severity, patient performance status, age and the availability of the HLA identical donor. Allogeneic BMT is the treatment of choice for the young (less than 25 years) SAA patients. It's side effects including graft versus host disease markedly increase with age. Immunosuppressive therapy is an option for patients older than 45, or younger ones with no HLA compatible donor. Optimisation of the treatment protocols is the subject of various ongoing randomised multicentre studies.