Hematopoietic stem cell transplantation(HSCT)is an important method to treat hematopoietic malignancies and some inherited diseases. Hematopoietic and immunological reconstitutions are the basis of successful transplantation. One significant obstacle to the success of HSCT is represented by graft failure,which severely endangers patients’ short-term survival. As human leukocyte antigen mismatched or haploidentical transplantation,and reduced intensity conditioning technology are more and more widely carried out,the incidence of implant failure increasing. With the study of the mechanism of implant failure and the clinical analysis of larger data,identifying important predictors of implant failure can help us to prevent this important complication of hematopoietic stem cell transplantation early. Here,we provide an overview on the recent advances in the concept,pathogenesis,related factors and treatment methods of hematopoietic stem cell engraftment failure.