Background: When it comes to childhood acute lymphoblastic leukemia (ALL) patients, Livin is related with good prognostic characteristics. Objective: The aim of the work was to assess livin expression in childhood B-lineage acute lymphoblastic leukemia to determine its significance. Patients and Methods: From September 2018 and September 2019, at Zagazig University Hospitals Clinical Pathology and Pediatric departments, our case control trial was conducted on 50 subjects, patients' group (25 cases of newly diagnosed ALL) and control group (25 healthy children). Assessment of livin expression was done using real time polymerase chain reaction (PCR). Results: There was statistically significant difference between the age of livin positive and livin negative cases (the mean age of livin positive cases was 6.2±3 years while the mean age of livin negative cases was 12.3±1.4 years). Mean livin expression level was significantly higher in age group < 10 than in age group group ≥ 10 years (294.53± 154.03 in age group <10 years versus 31 ±12.37 in age group ≥ 10). In livin negative group there were 3 patients with leucocytic count> 50.000/mm3 at diagnosis while 5 patients with leucocytic count ≤ 50.000/mm3 or more at diagnosis compared to 14 and 3 patients among livin positive group respectively (p=0.025). Regarding age, sex, WBCs, and risk stratification, there were statistically significant differences between the livin negative and positive groups. Conclusion: It could be concluded that livin was associated with favorable prognostic factors among ALL patients: (age<10 years, female patients, WBCs <50,000/mm3).