The incidence of myelodysplastic syndrome (MDS) is about 5 per 100,000 people in Europe, but rises to 20-50 per 100,000 people over the age of 60, which is clearly a high incidence among malignant diseases. As in China, the population of MDS patients is bound to grow in the next 10 years in Europe, where the elderly population is increasing. In the UK, due to the universal free healthcare system (NHS), it appears more evidence-based for doctors to treat patients following regularly updated treatment guidelines or nationally standardized clinical trials, which are more conducive to maximizing the benefits of treatment for patients. For MDS, individualized treatment is critical because the disease is highly heterogeneous, and even for the same subtype, the cellular characteristics and response to drug therapy can vary greatly from person to person and age to age. The strategies for the treatment of MDS in Europe, including the UK, are summarized in the following aspects: (1) The development of treatment strategies relies on a comprehensive assessment of the patient and a prognostic stratified assessment, generally divided into 4 groups: low risk, intermediate risk1, intermediate risk2, and high risk, according to the commonly used IPSS scoring system. (2) For patients in the low-risk or very low-risk group, that is, patients with only one lineage of hematocrit, no chromosomal abnormalities, and no primitive cells in the bone marrow, a watchful waiting strategy is recommended, but the need for timely monitoring and therapeutic intervention in the event of progression is emphasized. Therefore, for patients with low blood cells, who are able to maintain their quality of life, even with MDS features, physicians often recommend close observation and regular review. (3) For patients with intermediate risk 2 and high risk, allogeneic hematopoietic stem cell transplantation should be preferred for the appropriate population, and patients who are generally under 65-70 years old will be actively matched in the European bone marrow bank. (4) Patients with intermediate risk 1 are more often given combination therapy such as cell growth factors, immunomodulation, hypomethylating drugs such as heterozygous cytidine, decitabine treatment. A proportion of these patients with poor karyotype on karyotype examination will be recommended for transplantation. (5) For those patients who cannot be transplanted and are considered incurable, improvement of mortality due to hematocrit and maintenance of quality of life are the main goals.