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Oral manifestations are frequently the initial signs of leukemia, particularly in the acute forms, prompting the patient to consult the dentist first. The oral cavity, and especially the gingival tissue, is one site commonly involved either by leukemic infiltration or by inflammatory reactive hyperplasia causing gingival enlargement. The gingival infiltration may also be present without gingival enlargement. It is therefore imperative that the dentist recognize these leukemic lesions as early as possible because of the danger, in some instances, of oral surgical interference and also the necessity of medical attention. Therefore, gingival FNAC was performed as a diagnostic procedure with an aim to assess its diagnostic value in detecting leukemic gingival infiltration in acute leukemia patients presenting with or without gingival enlargement.