Speaking from the 2018 Society of Hematologic Oncology (SOHO) Annual Meeting in Houston, TX, Rashmi Kanagal-Shamanna, MD, of the MD Anderson Cancer Center, Houston, TX, gives an overview of recent key findings which have illuminated the pathology of myelodysplastic syndromes (MDS). She discusses how SF3B1 and TP53 mutations affect outcome and treatment planning in MDS, and gives her perspective on the crucial role that hematopathologists play in MDS research and treatment.