Recently published data have provided proof of a beneficial effect of enzyme replacement therapy (ERT) with imiglucerase in patients experiencing skeletal, hematologic, and visceral involvement from type 1 Gaucher disease. It is well established that the progression of the hematologic and visceral manifestations can be arrested with ERT. Recently, the work of Wenstrup et al has shown that long-term therapy with imiglucerase is effective at reversing the bone demineralization and bone crises often experienced by patients with progressive type 1 disease. Bone pain was also significantly decreased in these patients, effectively improving their quality of life. In addition, their work also evaluated the effects of varying doses of imiglucerase on bone mineral density and provides new hope for obtaining a normal bone mineral density in these patients without compromising safety and tolerability.