Secondary malignancies represent a relevant complication of chemotherapy employed for a previous cancer. Acute lcukemias represent the most frequent secondary malignaney in the first decade following primary neoplasms: Secondary leukemias are generally mycloid and can he preceeded by a myelodysplastie syndrome. The biological and epidemiological characteristics of secondary acute myeloid are well known and have been the subject of numerous reports and reviews in the last few years. The observation of a secondary acute lymphoblastic leukemia is considered rare, and the correlation with antecedent therapies is not definitive. Most of reported cases are single reports, and no large study has been performed to investigate the real importarice of this problem. In this review we report data of the current literature on secondary acute lymphoblastic leukemia, both in adults and children, in order to analyze its incidence and clinical and laboratory features.