Acute acalculous cholecystitis (AC) rarely occurs in children with acute leukemia. The principal treatment modality of AC is emergency surgery. Medical treatment of AC is not a good therapeutic approach. The mortality rate of AC is approximately 100% for medical treatment and 10-15% for emergency surgery. A 9-year-old boy with acute pre-B-cell lymphoblastic leukemia and AC caused by Salmonella paratyphi B infection is presented. He was successfully treated with cefepime, amikacin, and granulocyte-colony stimulating factor (G-CSF). These treatment combinations led to uneventful recovery after 21 days. It appears that AC in children with acute leukemia may be treated with appropriate intravenous antibiotics. This may be the first case of AC caused by Salmonella paratyphi B infection reported in a child with acute pre-B-cell lymphoblastic leukemia.