Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological malignancy. We reported a case of a 65-year-old male patient who was admitted with fever and nosebleed. Bone marrow aspirate and biopsy showed a cytoplasmic dendritic cell tumor expressing CD123, CD56, CD4, CD43，CD36, CD38, HLA-DR, CD2, and CD45RA. He received 2 cycles of hyper-CVAD-A regimen and high dose Ara-C+DXM+VDS+Peimantase as consolidation therapy. Afterward, he underwent umbilical cord blood transplantation (UCBT). The patient remained in remission at 10 months after diagnosis , but the patients died of relapse at 11 months after diagnosis. Therefore, elderly BPDCN patients in good general condition should be treated aggressively with high-dose chemotherapy and allo-HSCT, and in the absence of a suitable sibling donor, even elderly patients, UCBT can be an option to achieve rapid complete remission and long-term survival. However, how to deal with the recurrence and various complications after transplantation still needs more practice and exploration.