Objective: To evaluate the clinical therapeutic effect and safety of decitabine in the treatment for adult acute myeloid leukemia (AML). Methods: Clinical information from 15 patients (> 18 years) with adult AML were collected between August 2009 and October 2010. The therapeutic effect and side reactions of decitabine were evaluated. Results: Of the 15 patients, 3 patients achieved complete remission (CR), five patients achieved partial remission (PR). The overall response rate was 53.3%. Of the 12 patients whose cytogenetic evaluation was accessible, one patient (8.3%) achieved complete cytogenetic remission. The median overall survival (OS) was 123 d (27-509 d), the median relapse-free survival (RFS) was 70 d (19-306 d), and the median duration of response was 33 d (11-176 d). The incidence rate of grade IV hematologic toxicity was 93.3%, and the incidence rate of grade III-IV infection was 33.3%. No severe bleeding, nausea and vomiting and liver injury (grade III-IV) were observed. Early death occurred in one patient. Conclusion: Decitabine can effectively treat adult AML with more severe hematologic toxicity, and it is necessary to give active supportive treatment. Copyright© 2011 by TUMOR.