Fifty children with oral manifestations of acute leukemia, ranging in age from 1 to 14 years, have been studied with reference to age, sex, location and clinical presentation of the oral lesions. Seventy six percent of the patients had the disease during the first decade of their life, 22% as acute myelocytic leukemia and 54% as acute lymphocytic leukemia. In the current study, acute leukemia exhibited a high predilection for males (70%) and mucosal pallor was the most common presenting oral symptoms (39.6%). Erythema, ulceration and swelling of the lip, tongue, palate and gingiva were also frequent symptoms. Extra oral involvement occurred in 60% of the cases as facial pallor and 11% as lymph node enlargement.