While it has been well established that there are significant racial differences in lymphoid malignancies, registry-based studies have been limited by incomplete or missing data on stage, race, important clinical and laboratory prognostic factors, treatment, treatment response, and follow-up. To overcome some of these limitations, the authors conducted a retrospective cohort study of consecutive patients with a confirmed diagnosis of chronic lymphocytic leukemia (CLL) receiving care at MD Anderson Cancer Center and Duke University Medical Center. The authors identified 84 AA patients with untreated CLL who more commonly presented with poor-risk biological features such as unmutated IGHV gene, ZAP70 expression, and chromosome 17p or 11q deletion. . When compared to a group of non-black patients, the AA group had significantly shorter median event-free survival and overall survival. These results corroborate the findings of prior studies of CLL, but forward the field by providing additional clinical details to understand the nature of these racial disparities.