Seventeen patients with Sézary syndrome were treated with low-dose methotrexate for periods of up to 5 years (median follow-up 22 months). Seven patients (41%) achieved a complete response, and six patients (35%) achieved a partial response (more than 50% improvement). As of their latest evaluation, 10 of 17 (59%) were in a state of either complete or partial response. The estimated 5-year survival rate was 71% (standard error 13%). Toxicity was minor and self-limiting in only one patient. Clinical improvement was accompanied by a decrease in the circulating Sézary cell count.