Currently approved treatments for MDS include those aimed at reducing the transfusion burden and improving anemia in low-risk disease (recombinant erythropoietin, lenalidomide, and laspatercept) and those for prolonging survival in high-risk MDS. hypomethylating agent (HMA). However, these are not curative treatments, so allogeneic stem cell transplantation remains the only possible treatment. Patients eligible for clinical trials may benefit from investigational drugs. Treatment should be aimed at maintaining or improving health-related quality of life. This special issue outlines the unmet needs of patients with MDS and is designed to provide readers with a broader understanding of emerging biological insights integrated into current and future treatment options and their outcomes.