Autophagy is a conservative self-degradation system in eukaryotic cells, which involves in multiple physiologic and pathologic processes. Autophagosome is a typical characteristics of autophagic process, and its formation and degradation are the key points to control autophagy. Due to its dual characteristics to promote survival and death, to some extent, autophagy determines cell fate for survival or die. Autophagy plays important roles in cancer development, metastasis and drug-resistance. Thus targeting autophagy may provide novel strategies for treating cancer and overcoming drug resistance. With the advances of study on autophagy regulation in leukemia cells, the novel therapeutic targets and strategies to cure leukemia will be developed. This review focuses autophagy characteristics and regulation, autophagy and tumor, autophagy and leukemias as well as autophagy regulation in leukemia cells.