This study investigated the use of low dose methotrexate (MTX) (5 mg/m2/infusion) for the treatment of graft-versus-host disease (GVHD), after failure of corticosteroids. Twelve patients had refractory acute GVHD, while eight received MTX for severe chronic GVHD and/or the side effects of corticosteroids. Thirteen patients responded to MTX with six complete remissions and little toxicity, suggesting that low dose MTX is beneficial in refractory GVHD and deserves further investigations.