Abstract: Objective To summarize the experience of treating a severe aplastic anemia (SAA) patient with second haploidentical hematopoietic stem cell transplantation. Methods Clinical data about a severe aplastic anemia patient were analyzed and related literatures were reviewed to summarize its treating experience. Results A 45-year-old male who complained of blurred vision admitted to our department in 2015 with blood test and bone marrow biopsy showing acute severe aplastic anemia.We carried out a hematopoietic stem cell transplantation with his identical sibling sister (7/10 matched), and leukocytes was implanted on day +10, while he got a fever on day +26 resulting from graft rejection.The second transplantation was carried out at 48 days after the first transplantation with his daughter (5/10 matched).Leukocytes and platelets were implanted on day +12.The patient suffered from skin GVHD on day +39 which was cured after 5 days of methylprednisolone treatment, and he was discharged at 52 days after second transplantation. Conclusion For patient with SAA, if the first haploidentical hematopoietic stem cell transplantation has failed, second haploidentical transplantation is still a choice.