We are entering an exciting era in the management of chronic myeloid leukemia (CML). This, in part is related to our considerable understanding of the molecular lesion associated with the disease—arguably the best characterized of any malignancy. Although allogeneic hematopoietic cell transplantation remains the sole potentially curative therapy at present, newer agents such as the tyrosine kinase inhibitor STI571 show promise and may eventually replace less specific cytotoxic therapy. This review focuses on the numerous options currently available for treating CML and includes a treatment algorithm.