The relationship between telomere length (TL) and predisposition to myelodysplastic syndromes (MDS) remains unclear. We compared peripheral blood leukocyte (PBL) TL among cases of histologically-confirmed MDS (n=65) who were treatment-naive with no prior cancer history to age-matched controls (n=63). Relative TL was measured in PBL and saliva by quantitative PCR and in CD15+ and CD19+ cells by Flow-FISH. Human telomerase reverse transcriptase gene (hTERT) mutations were assessed by PCR. After adjustment for age and sex, relative TLs were reduced in PBL (p=0.02), CD15+ (p=0.01), CD19+ (p=0.25) and saliva (p=0.13) in MDS cases versus controls, although only PBL and CD15+ results were statistically significant. Among MDS cases, CD15+ and CD19+ cell TLs positively correlated (p=0.03). PBL TL was reduced among those occupationally exposed to paints and pesticides, but was not associated with hTERT genotype. Future studies are needed to further investigate constitutional telomere attrition as a possible predisposing factor for MDS.