The task of improving patient and caregiver satisfaction in the management of myelodysplastic syndromes (MDS) poses many challenges for physicians and patient care teams. Advances in the understanding of MDS biology have resulted in the approval of 3 agents for the treatment of MDS by the US Food and Drug Administration (FDA) in the past decade. However, according to a retrospective physician survey, the majority of recently diagnosed patients with MDS still receive supportive care only. Interestingly, a survey performed in patients with MDS suggests that patient understanding of treatment goals and prognosis is often limited, with a third of patients reporting that prognosis was not discussed with their physician. Efforts to improve patient awareness of their disease severity and establishing clear treatment goals are crucial for setting up an individualized treatment plan and ensuring optimal patient and caregiver satisfaction.