For patients with inherited BM failure (BMF) or those with acquired BMF who fail immunosuppressive therapy and who lack a suitable alternative donor, the prognosis remains poor. Umbilical cord blood transplantation has extended the availability of hematopoietic stem cell transplantation in the absence of a suitable donor. A recent EBMT study confirmed the feasibility of this treatment and highlighted the fundamental role of the TNC dose (>3.9 × 10(7)/kg TNC/kg) on both engraftment and OS using cord blood as stem cell source in severe aplastic anemia. However, this procedure is still experimental and should be evaluated only through prospective clinical trials.