Purpose:The aim of this study was to investigate the clinical factors related to hematologic toxicity caused by treatment with samarium-153 ethylenediaminetetramethylene phosphonic acid (153Sm-EDTMP). Materials and Methods: A total of 206 secondary bone neoplasm patients treated with 153Sm-EDTMP were analyzed retrospectively. Logistic regression (SPSS 10.0 for Windows; Chicago, IL) and correlation analysis were used to evaluate the factors concerned. Results: Age, number of bone metastatic lesions, chemotherapy before treatment with 153Sm-EDTMP, concurrence of radiotherapy, and times of repeated treatments with 153Sm-EDTMP were determined by single factor analysis to be related to hematologic toxicity. Chemotherapy before treatment with 153Sm-EDTMP, concurrence of radiotherapy, drug use to maintain normal white blood cell counts, and times of repeated treatments with 153Sm-EDTMP were determined by multiple factor analysis to be related to hematologic toxicity. Conclusions: Chemotherapy before treatment with 153Sm-EDTMP, concurrence of radiotherapy, drug use to maintain normal white blood cell counts, and times of repeated treatments with 153Sm-EDTMP are the main clinical factors related to hematologic toxicity caused by 153Sm-EDTMP therapy. In patients with such factors, more attention might be paid to the change of blood cell counts after 153Sm-EDTMP therapy.