Background: Dysregulation of epigenetics plays important roles in leukemogenesis and progression of acute myeloid leukemia (AML). Histone acetyltransferases (HATs) and histone deacetylases (HDACs) reciprocally regulate acetylation and deacetylation of nuclear histone, aberrant activation of HDAC results in uncontrolled proliferation and differentiated blockage, HDAC inhibitors have been investigated as therapeutic drugs for treatment of AML. Methods: Cell growth was assessed by CCK-8 assay, apoptosis was determined by flow cytometry in AML cell lines, CD45+ and CD34+CD38- cells from patient’s samples after stained with Annexin V-fluorescein isothiocyanate (FITC)/Propidium Iodide (PI). EZH2 expression was silenced by short hairpin RNA (shRNA). The pathway changes were detected by western blot. The effect of chidamide or EZH2 shRNA in combination with adriamycin was studies in vivo in nude mice model bearing leukemia.Results: In this study, we investigated the antileukemia activities of HDAC inhibitor chidamide and its combinatorial effect with cytotoxic agent in AML. We demonstrated in vitro and in vivo that chidamide suppressed expression of EZH2, exerted potential antileukemia activity and increased the sensitivity AML cells and AML stem/progenitor cells to chemotherapeutic drug through Smo/Gli-1 pathway. In addition to decrease the expression of H3K27me3 and DNMT3A, inhibition of EZH2 either pharmacologicall by chidamide or genetically by shEZH2 decreased the activity of Smo/Gli-1 pathway, and increased chemotherapeutic sensitivity in AML cells. Conclusions: Inhibition of EZH2 by chidamide has antileukemia activity and increases chemosensitivity, it provides a potential strategy to improve chemotherapeutic effect in AML.