【Objective】  To explore the outcome and side-effects in patients with myelodysplastic symdromes(MDS) treated with cyclosporine A without or with thalidomide.  【Methods】  To compare the outcome and side-effects in 30 patients with MDS, treated with cyclosporine A(CSA) as single agents (n=14, group A) or CSA combined with thalidomide (n=18, group B).  【Result】  there were no significant difference in hematologic or clinical features, Karyotype anomalies, classification of FAB or WHO, International Prognostic Scoring System(IPSS) score between the two group patients. Four patients of group A(28.5%) and twelve of group B (66.7%, P=0.011) achieved hematologic improvement. Three patients achieved a HI-E (three major), three patients HI-P(two major, one minor)and three patients HI-N(two major, one minor)within the group A. Twelve patients achieved a HI-E (eleven major, one minor), seven patients HI-P(five major, two minor)and six patients HI-N(three major, three minor)within group B. Two patients(2/11 cases,18.2%) became transfusion independence within group A, nine patients(9/14 cases, 64.3%)became transfusion independence within group B. There was statistic difference between two groups(P=0.021). Nine patients emerged hepatic lesion(three in group A(21.4%),six in group B (33.3 %), P=0.457), Three patients emerged nephrotoxicity(one in group A(7.1%), two in group B (11.1%) , P=0.702). These patients all made a recovery by treatment.  【Conclusions】  CSA combined thalidomide is an effective and relatively well-tolerated treatment regimen for patients with MDS.