Objective To compare the efficacy and toxicity of domestic and imported idarubicin (IDA) in the treatment of acute myeloid leukemia (AML).Methods 47 initial AML cases (except AML-M3) were treated with the classic inductive treatment,which was IDA (10 mg·m-2·d-1,d1-d3) combined with cytarabine (Ara-C,150 mg·m-2·d-1,d1-d7).The patients were divided into domestic IDA group (17 cases) and imported IDA group (30 cases).The differences of clinical efficacy and toxicity between two groups were observed after inductive treatment for 1 course.Results The complete remission (CR) rates in domestic and imported IDA groups were 70.6 ％ (12/17) and 70.0 ％ (21/30),respectively,and the total effective rates were 88.2 ％ (15/17) and 80.0 ％ (24/30),respectively,there was no significant difference between two groups (P =0.453).The severe bone marrow suppression during the inductive treatment was found in both groups,including agranulocytosis lasted (11.64±5.47) days and (12.66±3.82) days,respectively,and platelet ＜ 20× 109/L lasted (11.61±4.20) days and (12.97±5.29) days,respectively.Infection rates in two groups were 64.7 ％ (11/17) and 76.7 ％ (23/30),there is no statistical significance between two groups (P ＞ 0.05).There was one case dead of sepsis and intracranial hemorrhage in each groups,respectively.The rates of the gastrointestinal toxicity were 17.6 ％ (3/17) and 13.3 ％ (4/30),respectively.2 liver dysfunction cases was observed in imported idarubicin group.There were no damages of heart and kidney for the chemotherapy drugs in both groups.Conclusion The efficacy and toxicity of domestic IDA is consistent with that of imported IDA in treatment of AML.