119 children with acute lymphoblastic leukemia at onset underwent radiography of the whole body in order to determine whether initial radiological bone lesions were correlated with subsequent clinical course. Radiological findings were divided into three groups: 101 children (84.8%) had no bone involvement (group 0); 10 had bone changes compatible with acute lymphoblastic leukemia, such as slight metaphyseal transverse lucent bands with or without diffuse demineralization (group 1); 8 had bone changes, such as periosteal reaction with or without intramedullary osteolytic mottling. Bone involvement was not correlated with prognostic factors. Furthermore there was no significant correlation between bone changes and complete remission or survival.