The therapeutic management of chronic sclerodermatous graft-vs-host disease (GVHD) is challenging because, apart from systemic corticosteroids, no treatments have shown clear benefits in terms of long-term effectiveness or tolerability. In this retrospective study, the authors describe their experience with the use of imatinib to treat chronic sclerodermatous GVHD in 18 patients who did not respond to systemic corticosteroids. The majority of patients (83%) responded at least partially and the treatment also permitted corticosteroid tapering in a high proportion of cases (78%). Imatinib is a potent tyrosine-kinase inhibitor that is used in GVHD because of its dual inhibitory activity against platelet-derived growth factor receptor and transforming growth factor-β. There is no evidence from clinical trials to support the use of imatinib in chronic sclerodermatous GVHD. This study, however, adds to data from other series in which imatinib has improved symptoms and achieved response rates of between 50% and 79%, with lower rates observed in older patients and patients with more advanced lung disease.1 Imatinib is also a relatively well-tolerated drug associated with low levels of discontinuation due to adverse effects. Despite the retrospective nature of this study, its results add to the body of evidence on the effectiveness of imatinib in the management of chronic sclerodermatous GVHD. Prospective studies, however, are needed to confirm these preliminary results.