Science and Education Publishing American Journal of Medical Case Reports 2374-216X 3 4 2015 02 27 A Case Report on Acute Lymphoblastic Leukemia in A 10 Days Old Neonate 95 97 EN Prahlad Neupane Prasanna Dahal Clinical Pharmacist (Msc, PharmD) Bijayapur Hospital, Dharan-10, Sunsari, Nepal Birat Acharya Sagar raj pandey Ramesh Gautam AJMCR2015342 10.12691/ajmcr-3-4-2 2014 12 29 2015 02 14 2015 02 27 Although leukemia's are the most common malignant disease seen in children, it occurs rarely in neonates. Only few cases of congenital leukemia have been reported in literature. We report here a rare case of congenital lymphoblastic leukemia in a 10 days old full term male neonate of normal home delivery who presented in the hospital with complaints of fast breathing and fever of 1 day duration. Initial clinical manifestation was that of Multi organ dysfunction syndrome due to late onset neonatal sepsis but was found to have acute leukemia on subsequent investigations.