To explore the role and mechanism of apoptosis in severe acute respiratory syndrome (SARS). Klenow-FragELTM DNA Fragmentation Detection Kit and immunohistochemical alkaline phosphatase detection reagent kit were used to detect cell apoptosis and expressions of CD68, CD20, CD4, CD8 and CD45RA in the pathological tissues of SARS patients. Apoptotic cells increased significantly in the spleen, lung and lymph nodes of SARS patients as compared with normal tissues. The apoptotic cells included pneumocytes, lymphocytes and monocytes, and CD68+ monocytes were observed in abundance in the lung, spleen and lymph nodes of SARS patients. In the lung tissue of the patients, few CD20+/CD45RA+ B cells and CD4+/CD8+ T cells were spotted, and CD20+/CD45RA+ B cells along with CD4+/CD8+ T cells were also significantly decreased in the spleen and lymph nodes, where few conserved B and T cells underwent apoptosis. Apoptosis is a general phenomenon in SARS, and the invasive cells in the pathological tissues are primarily monocytes, suggesting that apoptosis and invasion of monocyte play important roles in the progression of SARS. The cell apoptosis and decreased number of T cell and B cells in the lungs and CD4+/CD8+ T cells and CD20+/CD45RA+ B cells in the spleen and lymph nodes indicate that the SARS virus may exercise immune cell-killing effect to some extent during its pathogenesis.