OBJECTIVES: To evaluate the therapeutic indication of 25 mg, 100 mg and 200 mg injectable lyophilised powder antithymocyte immunoglobulin (rabbit) for the treatment of aplastic anemia. METHODS: A literature search was carried out on February 2015 in the following databases: BMJ - Best Practice, Dynamed and UpToDate. The search strategy adopted the vocabulary of structured Descriptors in Health Sciences (DeCS) and Medical Subject Headings (MeSH) to better identify the references of interest. Indexed search terms used were: "Anemia, aplastic" and "Antithymocyte Globulin rabbit". RESULTS: According to evidences in BMJ, the use of antithymocyte immunoglobulin is indicated as first-line treatment in patients with aplastic anemia in groups of patients with non-severe, severe or very severe acquired disease over the age of 50 years. According to Dynamed database, the use of antithymocyte immunoglobulin at a dose of 15 mg/kg/day for 5 days with prednisolone and cyclosporine 5 mg/kg/day for 6 months improves the response rate and the free time of blood transfusions. Since the evidence synthesis found in UpToDate base demonstrates that for the treatment of severe or very severe aplastic anemia there should contain a combination of: removing potentially offending agents (for acquired aplastic anemia), additional supportive care (for example, transfusion and antibiotics) and some form of definitive therapy (e.g., transplantation of hematopoietic cells or immunosuppressive regimens). Since 2014, none of the published studies comparing horse and rabbit immunoglobulin showed superiority of the latter. It should only be used when the horse derivative is not available. CONCLUSIONS: Because human antithymocyte equine immunoglobulin is not available in Brazil, we recommend the inclusion of rabbit antithymocyte immunoglobulin in dosages of 25 mg, 100 mg and 200 mg, in the form of injectable lyophilized powder in the National List of Essential Medicines of Brazil.