The group of clean-up workers involved in the liquidation of the consequences of the major accident at the Chemobyl nuclear power plant (CNPP) was exposed to high doses of radiation. In this review, we summarize the results of a long-term study of the cytogenetic status of CNPP clean-up workers. The data revealed different trends of the parameters of the cytogenetic status in the course of the study. The results of biological dose reconstruction, based on the frequency of mutant T-helper cells, are discussed.