A 37-year-old male was treated successfully by peripheral blood stem cell transplantation (PBSCT) from his HLA-identical sister for refractory acquired pure red cell aplasia (PRCA). The conditioning regimen was cyclophosphamide 50 mg/kg/day for 4 days plus TBI 300 cGy in a single fraction. Absolute neutrophil count (ANC) >500/μl and platelet counts >20,000/μl were achieved 8 days after PBSCT without transfusion. Chimerism study on day 218 revealed full donor chimerism. The hemoglobin level was stable around 12–13 g/dl with normal leukocyte and platelet counts after PBSCT during a long follow-up period. From this case, PBSCT should be considered for patients with refractory acquired PRCA with an HLA-identical donor. Am. J. Hematol. 74:273–275, 2003. © 2003 Wiley-Liss, Inc.