Objective: To detect the methylation status of DLC-1 gene in the patients with myelodysplastic syndrome(MDS), the effect of abnormal methylation of DLC-1 gene on the expression of DLC-1 gene, the clinical significance of methylation of DLC-1 gene in MDS patients, and the effect of decitabine on DLC-1 gene expression. Methods: A total of 43 MDS patients were treated in Fujian Medical University Union Hospital from 2013 to 2015. Methylation status of DLC-1 gene in MDS patients were detected by the methylation specific PCR(MSP). The expression of DLC-1 gene mRNA was determined with real-time fluorescence quantitative PCR(RTFQ-PCR). MDS patients were divided into 5 groups (very low-risk, low-risk, intermediate-risk, high-risk and very high-risk, n=0, 8, 7, 18, 10) according to WPSS classification. And the clinical significance of methylation of DLC-1 gene in patients with MDS were investigated. In order to investigate the change in gene methylation and expression of DLC-1 gene after treatment with decitabine, methylation statuses of DLC-1 gene in MDS patients before and after be treated with decitabine were detected by the bisulfite sequencing PCR(BSP). The expressions of DLC-1 gene mRNA of these patients were determined with RTFQ-PCR. Results: Hypermethylation of CpG island of DLC-1 gene was observed in 55.16%(22/43)MDS patients. The expressions of DLC-1 gene mRNA in methylation positive patients were significantly lower than that in methylation negative patients (0.32±0.06 vs 0.91±0.11)(P=0.008). For MDS patients, the DLC-1 methylation rate of intermediate-and high-risk patient was 21/35, which was significantly higher than that of low-risk patient(1/8, P=0.006). The methylation status of DLC-1 gene were monitored in 8 patients before and after treatment with the decitabine (decitabine 20 mg/m(2,) d1-d5/d28, more than 4 courses) , the methylation rate of DLC-1 gene dropped from 57.50%±5.11% to 14.13%±2.07% after treatment(P=0.010). The expression of DLC-1 gene increased after treatment with decitabine(0.67±0.08 vs 0.28±0.06, P=0.015). Conclusions: Methylation of DLC-1 gene is common in MDS patients and may be associated with poor prognosis. Decitabine may activate the expression of DLC-1 gene by demethylation, which may be one of the mechanisms for the treatment of patients with MDS.