Immunoglobulin light chain amyloidosis is the most common type of systemic amyloidosis. Hematopoietic stem cell transplantation (HCT) is an effective treatment option for AL however due to multi-organ involvement in this disease HCT is feasible in a minority of patients. To maximize the benefit and minimize toxicity it is of paramount importance to optimize the selection of patients for HCT. In this review we discuss evolution of HCT and its typical application to a case of AL amyloidosis.