Highlights: • This ESMO Clinical Practice Guideline provides key recommendations for managing myelodysplastic syndromes • It covers diagnosis, classification, staging and risk assessment of myelodysplastic syndromes • Treatment recommendations for lower- and higher-risk myelodysplastic syndromes are also provided • All recommendations were compiled by a multidisciplinary group of experts • Recommendations are based on available scientific data and the authors’ expert opinion Key words...