There is no published data regarding adult acute leukemia (AL) in the United Arab Emirates (UAE). Our objectives were to determine the distribution and incidence of adult AL in UAE (nationals and non-nationals). This epidemiological survey recovered 263 adult patients with AL diagnosed between January 2000 and December 2006 with a median age of 34 years. Twenty-four percent were UAE nationals and 63% were males. Acute lymphoblastic leukemia (ALL) was more frequently diagnosed (32%) than in western countries. This clearly reflects the population structure of the UAE which consists of predominantly young males. There is a tendency for lower crude and age-specific incidence rates of AL, acute myeloid leukemia (AML) and ALL in the UAE when compared with those in western countries. We found a statistically significant higher incidence of AML among national females than in national males (p = 0.04). This is reflected in a significantly higher incidence of AL (p = 0.02) and AML (p = 0.02) among the females when compared with the males in the total population of the UAE. This result contradicts the generally known finding that AML and ALL are more common in males. The implication of cumulative risk factors to which females could be exposed, such as vitamin D deficiency as a result of sunlight deprivation and direct exposure to benzene and color enhancement chemicals in henna, could not be excluded and warrant further investigation.