In myelofibrosis (MF) patients, the standard of care curative (SOC) option is through an allogeneic-hematopoietic stem cell transplantation (allo-HSCT); however, no SOC pre- and post-transplant management exists. To report outcomes of MF patients, post-allo-HSCT at our institution with consideration of patient characteristics, risks, and pre-transplant treatment. A retrospective chart review. Single institution: academic center hospital/county hospital Patients or Other Participants: 18-99YO M/F patients with MF diagnosis by bone-marrow biopsy since 2012-2020 and received allo-HSCT at our institution. Chart review. Primary: OS, PFS since time of transplant, stratified to JAK2 inhibitor use, MF type and associated patient characteristics/risks. Secondary: Patient/treatment characteristics, response/mortality rates. P≤ 0.05 is considered significant. In 18 patients, median age 60.7 years 61.1% White/Non-Hispanic, 16.7% Hispanic with 44.4% high, 55.6% intermediate-1/2 risk by DIPSS, 27.8% high and 33.3% very high risk by MIPSS70+. 66.7% had primary MF. At time of transplant, 11.1% was CR/PR, 38.9% SD, and 50% PD. 38.9% received MSD, 27.8% MUD, and 33.3% received haploidentical stem cells. 76.5% had RIC and 23.5% underwent MAC. 44.4% were +JAK2 V617F, 16.7% had either: ASXL1, EZH2, SRSF2, IDHL1/2, U2AF1. 11.1% had high-risk karyotype/cytogenetics. 61.1% received a JAK2 inhibitor, 72% received non-JAK2 inhibitor treatments pre-transplant. Post-transplant, 78% alive at 1 year. Since transplant, 3-year (3y) OS was 66.7% in primary MF patients, 55.6% in secondary (p=0.75) with similar EFS. 3y-OS in JAK2 V617F+ patients was 83.3% (p=0.13) with similar EFS. 3y-OS of those who received a JAK2 inhibitor pre-transplant was 47.7% (p=0.17) with similar EFS (p=0.16). Those without either ASXL1, EZH2, SRSF2, IDHL1/2, or U2AF1 mutations achieved a higher, 72.2%, 3y-OS (p=0.076) than those with any. High-risk karyotype/cytogenetics 3y-OS was 50% (p=0.43). OS/EFS rates were generally lower with higher DIPSS and MIPSS70+. Given most of our patients were high/very high risks, achieving 3y-OS of 66.7% in primary and 55.6% in secondary MF since the time of transplant is appreciable. Interestingly, even with higher OS/EFS for JAK2V+ patients, the OS/EFS is lower for those who received a JAK2 inhibitor. This could be from the low sample size. Further studies are necessary.