Introduction: Leukemia is the most common pediatric malignancy. Acute lymphoblastic leukemia accounts for about one-fourth of all childhood cancers and about 75% of all childhood leukemias. Recent advances in therapy such as aggressive polychemotherapy, intrathecal cytostatic prophylaxis for pediatric leukemia have greatly improved the prognosis but have resulted in an increased incidence of associated complications and toxic effects. The main neuro-imaging features in pediatric patients with leukemia treated with chemotherapy were prospectively studied. Patients and methods: 20 pediatric patients their age range 1-16 years receiving or have received chemotherapy for acute leukemia have undergone MR examination of the brain for evaluation of neurological symptoms related to treatment at the national cancer institute from April to August 2013. Conclusion: Chemotherapy is associated with certain side effects that can be evaluated by utilization of MRI. An elevated degree of suspicion is needed to recognize the radiologic features of CNS complications of chemotherapy and familiarity with the imaging findings is essential for proper diagnosis and further treatment of neurologic symptoms in pediatric patients with leukemia.