This paper aims to make a comparative study of survival to MSK in pediatric leukemia based study of individual data for 300 children in Iraq.A retrospective study was conducted in different hospitals in Iraq where all medical records from 20-1-2019 to 4-2-2022 were reviewed for children under the age of 14 years as 300 children were included in this study, distributed in two groups (No MSK involvement, 200 children, and MSK involvement 100 children. Data and demographic information about children suffering from Lekima were collected from different hospitals in Iraq, where the data was designed and collected in this retrospective study by collecting 300 children distributed into two groups. Patients' information, including blood preparation, blood chemistry, ALL, and the year of diagnosis, were recorded. immunophenotyping of cell surface markers was additionally used to differentiate subtypes (i.e., AML from ALL, and T-cell ALL from B-cell ALL) Risk classification was based on NCL of patients aged 1 to 14 years and was enrolled WBC values less and higher than 109 * 50 Of 300 childhood leukemia cases, 100 (33.3 %) children had MSK involvement at initial presentation. MSK involvement was more likely in children with acute lymphoblastic leukaemia than acute myeloid leukemia (p < 0.05).Hematologic abnormalities were less frequent in the MSK involvement group (p < 0.05). The absence of peripheral blast cells was significantly higher in the MSK involvement group.