This study analysed the clinical outcome of salvage therapy consisting of aclarubicin (ACR) plus behenoyl cytarabine (BHAC) and prednisolone (PSL) for patients with acute myeloid leukemia (AML). ACR was administered at a dose of 13 mg/m2 per day for 14 days; BHAC, at 130 mg/m2 per day for 14 days; and PSL was administered orally at a dose of 60 mg/m2 per day for 5 days. Of 47 patients, 25 (53.2%) achieved CR. The CR rates of patients in whom induction failed was 55% and that of relapsed patients was 51.9%. Four patients received allogeneic hematopoietic stem cell transplantation after achieving CR. Five patients achieved long-term survival without relapse. The 10-year relapse-free and overall survival rates were 20% and 10.6%, respectively. ACR in combination with BHAC showed a substantial anti-leukemic efficacy in previously treated AML patients and the role of ACR and BHAC may be considered while devising strategies for AML treatments.