We present a case of acute myeloid leukemia (AML) in an elderly male. A severe hypodiploid karyotype (chromosome range 29-39) was detected with a large amount of cell-to-cell variation, suggesting that the leukemic cells are primarily characterized by chromosomal loss due to karyotypic instability. Severe hypodiploidy is a rare finding in AML but previous similar cases indicate that it confers a very poor prognosis.