Most patients with Acute Lymphoblastic Leukemia (ALL) have an abnormal clone by conventional cytogenetic studies. At least 36 chromosome anomalies have been identified in this disorder. Most common Karyotype among children with ALL is Hyperdiploidy which is associated with a good prognosis and may be associated with Trisomies of chromosomes 4,10 & 17. These anomalies are important to detect as they are critical prognostic markers. Presence of t(12;21)(p13;q22) is associated with an excellent prognosis and transplantation is rarely considered.