This study reported a relapsed case of acute promyelocytic leukemia with complex chromosomal aberrations of double ider (17q-) and explored its laboratory and clinical features. Immunophenotypic analysis was performed by multiparameter flow cytometry. Conventional cytogenetics was used for karyotyping analysis. Fluorescence in situ hybridization (FISH) and multiplex fluorescence in situ hybridization (M-FISH) were also used to identify the chromosomal aberrations. The results demonstrated that karyotype was 47, XY, 1p-, 15q+, ider (17q)x2, FISH showed five fusion signals in a same interphase cell, and M-FISH confirmed the abnormalities. Immunophenotypic analysis showed positive expression of CD13 and CD33, while no expression of CD34, HLA-DR, or T, B lymphocyte markers. In conclusion, double ider (17q-) is a rare additional abnormality in APL patients; combination of FISH with M-FISH techniques is a reliable way to identify such complicated chromosomal aberrations.