Thanks to advances in treatment, approximately 85-90% of patients suffering from Wilms' tumour are now cured. However, success rate after relapse is significantly lower, ranging from 25 to 45%. Several different re-induction approaches, more or less intensive according to first-line therapy and characteristics of relapse, have been proposed. A number of adverse prognostic factors related to a bad outcome after relapse have been identified and are used as inclusion criteria for entering in a programme including high-dose chemotherapy (HCT). HCT followed by autologous haematopoietic stem cell rescue has been used in small numbers of patients worldwide and promising results have been reported. Information from the European Group for Blood and Marrow Transplantation Database regarding more than 300 transplants have been gathered. In addition, literature data on rescue therapy and HCT will be discussed, such as recent treatment proposals currently under discussion within European and US cooperative groups.