Myelofibrosis (MF) is a blood cancer characterized by fibrotic bone marrow and altered hematopoiesis. Although the prevalence of MF is low, its severe symptoms have a significantly negative impact on patient quality of life, and its ability to transform into leukemia increases morbidity. Conventional drug therapies provide modest symptom palliation, but allogeneic stem cell transplantation has been the only treatment capable of affecting MF's natural history. Ruxolitinib (Jakafi®) is a new targeted therapy indicated to treat patients with intermediate- and high-risk MF. Although the research is conflicted regarding ruxolitinib's ability to affect survival or induce remission, studies show that it offers dramatic improvements in symptom management. However, ruxolitinib carries some potentially life-threatening adverse effects. This article reviews ruxolitinib, discusses its risks and benefits, and describes the vital role of oncology nurses in education, monitoring, and support.