To analyze CD200 and CD56 expression by flow cytometry in acute lymphoblastic leukemia patients and whether their overexpression had prognostic impact individually and in combination with each other. Seventy newly diagnosed patients were assessed, of whom 27 were adult ALL and 43 pediatric ALL. Forty seven of 70 cases (67%) showed CD200 expression, and 7 cases (10%) showed CD56 expression but only 3 cases (4.3%) had expression for CD200+ and CD56+. Significance differences were found between CD200& CD56 expression in whole ALL patients group compared to control group (P<0.0001and P<0.001respectively). Splenomegaly and lower hemoglobin and platelet were more frequently observed in CD200+ patients whose also associated with significant increase of myeloid marker CD34 frequency. There were significant differences in overall survival (P= 0.042, P= 0.006) and disease-free survival (P= 0.005, P= 0.002 ) between the CD200+ and CD200- patients in total ALL patients and adult ALL . Whereas, in pediatric ALL OS of CD200+ patients 35.7% compared to 86.2% in CD200-, P= 0.032 but DFS showed non-significant difference (P=0.099). On the other hand, CD56+ patients had lower complete remission rate (14.3% vs. 63.5%, P= 0.018). CD56+ had significant influence on overall than those of CD56- (28.6% with mean 4.7 months vs. 41.1% with mean=11.8 months, P= 0.003) and disease free survival (40% with mean=6.26months vs. 54.9% with mean=14.16, P = 0.006). In respect to combination of two CDs positive had very inferior OS and DFS (mean =0.533 month and 0.150 month). In addition to, increased frequency of CD34 was associated with CD200+, CD56+ patients.