Selected unapproved uses of epoetin alfa are reviewed as Part II of a two-part article. The drug is approved by the Food and Drug Administration (FDA) for only four indications as listed in Part I of this review; however, there are a growing number of therapeutic uses of this drug for other disease states. This review discusses the unapproved and possibly lesser-known therapeutic uses of this medication. An extensive literature search of PubMed was conducted to identify studies published from 1989 to December 2003. The following conditions for the use of epoetin alfa are discussed in this review: Chronic diseases, Jehovah's Witness patients, radiation therapy, Epidermolysis Bullosa, porphyria, athletic enhancement, sexual dysfunction, and transfusional iron overload. The authors have summarized published studies of the use of epoetin alfa in the disease states including their recommendations.