This study was conducted to evaluate the efficacy and safety of gemcitabine-based combination regimen in patients with peripheral T-cell lymphoma (PTCL). Between May 2007 and August 2011, 26 consecutive patients with PTCL were enrolled in this study. Of these 26 patients, histology was extranodal NK/T-cell lymphoma, nasal type in 14 (53.9 %), peripheral T-cell lymphoma, not otherwise specified in nine (34.6 %), anaplastic large cell lymphoma, ALK negative in three (11.5 %). The majority of patients had newly diagnosed (65.4 %) and advanced (80.8 %) diseases. Treatment regimen was DIMG (dexamethasone, ifosfamide, methotrexate, and gemcitabine) given to the first 6 patients, and GDP (gemcitabine, dexamethasone, and cisplatin) given to the remaining 20 patients. The median follow-up time was 25 (range 7-60) months. The overall response rate was 88.5 %. Twelve (46.2 %) patients achieved complete remission, 11 (42.3 %) patients achieved partial remission, and 1 (3.8 %) patient had stable disease (SD), two (7.7 %) patients had progressive diseases. The 1- and 2-year progression-free survival rates were 58.7 and 45.9 %, while 1- and 2-year overall survival rates for all patients were 80.6 and 63.7 %, respectively. Adverse events included grade 3 or 4 neutropenia (35.0 %) and thrombocytopenia (15.0 %) from patients treated with GDP. Grade 3 or 4 neutropenia and thrombocytopenia were 100.0 and 66.7 %, respectively, for patients who received DIMG regimen. Our study has demonstrated that the gemcitabine-based combination regimen, especially GDP regimen, is safe and well tolerated with promising clinical activity in patients with PTCLs.