Objective To investigate the mechanism of arsenic trioxide (As2O3) -induced apoptosis in acute promyelocytic leukemia(APL)NB4 and HL60 cells.Methods NB4 and HL60 cells were treated with As2O3 at different concentrations. Cell proliferation was determined by WST-8 assay. The apoptosis rate was detected by flow cytometry with annexinV-FITC/PI double staining.The mRNA expression of apoptosis-related genes caspase-3, Caspase-8, Caspase-9, Bcl-2,Bax, the proto-oncogene C-myc, survivin, p53 and granulocytes differentiation antigen CD11b was detected by RT-PCR. The expression of apoptosis-related proteins caspase-3, Caspase-8, Caspase-9, Bcl-2,Bax was determined by Western blotting. Results Arsenic trioxide proliferation of NB4 and HL60 cells with similar sensitivity. As2O3 induced apoptosis of NB4 cells, but induced HL-60 differentiation to mature stage. Western blot detection and RT-PCR results showed that As2O3 treatment caused up-regulation of Bax, caspase-3, Caspase-8, Caspase-9, CD11b mRNA levels, and protein levels of caspase-3, Caspase-8, Caspase-9 in both cell lines. The expression of survivin, C-myc, Bcl-2 and mutated p53 in NB4 cells treated with As2O3 significantly decreased. The expression of C-myc in HL60 cells treated with As2O3 significantly decreased, but survivin and Bcl-2 expression levels were not changed. Conclusion Arsenic trioxide can effectively inhibit proliferation of NB4 and HL60 cells, and induce apoptosis of NB4 cells, while induce HL-60 differentiation to mature stage. These effects may be associated with the altered expression of survivin, Bcl-2 and mutated p53 genes.