Abstract: Strontium-89 chloride (hereinafter referred to as "⁸⁹Sr") is a radiopharmaceutical for the treatment of bone metastases, especially systemic multiple bone metastases, but its clinical application is limited due to the adverse effect of myelosuppression. In addition to the radiobiological effects of ⁸⁹Sr itself, bone tumor burden during ⁸⁹Sr treatment, radiotherapy, chemotherapy and anti-androgen therapy before ⁸⁹Sr treatment are all important factors leading to myelosuppression. The authors review the related factors of myelosuppression induced by ⁸⁹Sr treatment of bone metastases.