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Objective. – The authors had the aim of determining the epidemiology of nosocomial infections (NI) in a pediatric subgroup of acute lymphoblastic leukemia (ALL).Design. – This 5-year retrospective study in a pediatric onco-hematology unit analyzed the data of 67 de novo ALL cases (49 B ALL and 18 T ALL cases, sorted in low, average, and very high risk patients) and 10 cases in relapse. All these patients were treated according to the same European treatment protocols and a central venous catheter was inserted as soon as the diagnosis was confirmed.Results. – Twenty-nine NI were diagnosed in these 77 children, mostly during the induction period. Bacterial NI were predominant, fungal and viral infections seemed to remain only a minor threat. The most common bacteria were staphylocci, linked to the major predisposing factors such as central venous catheter and immunosuppression due to leukemia and its treatment. Moreover, the high-risk group of ALL seemed to predispose to NI in our population. Four cases in our cohort showed specific prophylactic and curative problems concerning multiresistant bacteria.Conclusions. – In this specific immunocompromised population, NI was always a predominant complication. Moreover, high-risk of leukemia was described as a new predisposing infection factor. Specific prophylactic and curative efforts are needed to improve the treatment and the outcome of this type of patients. [Copyright &y& Elsevier]