Objective: Several mechanisms were found in the chronic lymphocytic leukemia (CLL) cell apoptosis-resistant process. The objective of this study was to investigate expression of anti-apoptotic gene XIAP in CLL patients and its clinical association with established prognostic factors(IgVH mutation status and CD38 expression). Methods: A total number of 37 CLL patients and 28 age-matched normal control were enrolled in this study. XIAP mRNA expression was detected by SyberGreen-based real-time PCR, clinical relationship was analyzed by GraphPad Prism software. Results:XIAP median expression was 0.04040(95% CI∶0.01610-0.06471) in CLL group compared to 0.07502(95% CI:0.04383-0.1062) in normal control group (P=0.0025); further sub-groups analysis implicated that XIAP expression was higher in drug-resistant group than that in drug-sensitive without statistical difference(P=0.3978), IgVH non-mutated status and positive CD38 expression were associated with higher XIAP expression. Conclusion:Abnormal XIAP mRNA expression as found in CLL patients with significant correlation with established prognostic factors and potential role in drug resistance, and XIAP may become a new supplement of CLL prognostic markers.