The optimal management of Waldenstrom's macroglobulinemia (WM) is in evolution, especially since the introduction of novel agents for its sister disease, multiple myeloma. Literature on the utility of autologous stem cell transplantation (ASCT) in WM, albeit mostly retrospective, supports its efficacy for symptomatic disease in eligible patients. Here, we present the experience of managing WM at our single institution. We report that ASCT improved OS/EFS in both treatment-naive and previously treated WM patients. Elevated LDH emerged as a poor prognostic factor in both univariate and multivariate analyses. Based on these data and other series of autologous SCT experience, it may be feasible to employ this strategy upfront in transplant eligible WM patients when they require a therapeutic intervention for symptomatic disease.