Although the presence of -ITD, as well as levels of the -ITD allelic ratio, have been described as prognostic factors in acute myeloid leukemia (AML), little is known about how the -ITD allelic ratio impacts patients' outcomes when receiving an allogeneic hematopoietic stem cell transplantation (HSCT). We analyzed 118 patients (median age at diagnosis 58.3, range 14.3-82.3 years) harboring -ITD, of whom 94 patients were consolidated with an allogeneic HSCT and included in outcome analyses. A high -ITD allelic ratio was associated with a higher white blood cell count, higher blood and bone marrow blasts, and worse ELN2017 risk at diagnosis. Patients with a high -ITD allelic ratio more often had mutations, while patients with a low allelic ratio more often had -TKD mutations. Patients with a high -ITD allelic ratio were less likely to achieve a measurable residual disease (MRD)-negative remission prior to allogeneic HSCT and had a trend for a shorter time to relapse. However, there was no distinct cumulative incidence of relapse, non-relapse mortality, or overall survival according to the -ITD allelic ratio in transplanted patients. While co-mutated -TKD was associated with better outcomes, the MRD status at HSCT was the most significant factor for outcomes. While our data indicates that an allogeneic HSCT may mitigate the adverse effect of a high -ITD allelic ratio, comparative studies are needed to evaluate which -ITD mutated patients benefit from which consolidation strategy.