Acute leukemia is reported to be less common in developing countries compared to non-Hodgkins lymphomas which is the most common childhood malignancy. A retrospective analysis was performed to identify the clinicopathological features of acute leukemias of childhood at the Oncology Department of Allama Iqbal Medical College, Lahore. The commonest malignancy in the under 15 years age group was leukemias (54%) followed by non-Hodgkins lymphomas (16%). Acute lymphocytic leukemia (ALL) was the commonest subtype (82%) followed by acute myeloid leukemia (16%). Peak incidence occurred in the 2.5-5 years age. The median duration of symptoms prior to diagnosis was 5 months. We conclude from our study that the incidence and clinicopathologic paediatric ALL is similar to that reported in the Western literature, unlike reports from other developing countries. Various environmental, viral and dietary carcinogens may play a major role in the etiology of leukemias.