Background: Acute leukemia is considered as the most popular hematological neoplasm, reflected by presence of precursor cells of malignant clone in peripheral circulation and bone marrow. Objectives: Our survey was done to evaluate the role of new prognostic factors as body mass index in adult patients receiving induction chemotherapy for acute myeloid leukemia. Patients and Methods: this study was carried out during the period from February 2018 to February 2019 in Clinical Hematology Unit, Internal Medicine Department of Zagazig University Hospitals. The study is Cross sectional of total subjects included 80 patients who were diagnosed as acute leukemia; 28 of them were females and 56 were males. Body mass index (BMI( is defined as the summation of division of weight calculated in kilograms by the square of height calculated in meters (kg/m2) Results: We found a statistically significant difference between the overweight patients and underweight patients regarding primary induction failure (PIF) rates. There is an increase in rates of PIF in the group of underweight patients than overweight group. Patients whom BMI is more than 25 can carry better results than underweight patients whom BMI > 25 as regarding to induction chemotherapy outcomes and overall survival, it may be due to increased period of chemotherapy distribution through the obese patients body with low rates of drug clearance. Sensitivity and specificity of BMI as a predictor for detection of response was calculated under cut-off range. There was an increase in rates of death rates in the group of underweight patients than overweight group. In addition to Disseminated intravascular coagulation was more frequently observed in the underweight group as compared to the normal and overweight groups. BMI level cutoff > 26.4 the sensitivity was 75 % and specificity was 66.67 % and Sensitivity and specificity of BMI as a predictor for detection of primary induction failure was calculated with cut-off range ≤28.7, the sensitivity was 83.33 % and specificity was 49.02 % . and specificity of BMI as a predictor for detection of death was calculated ≤ 26.6 , the sensitivity was 90.91 % and specificity was 59.42 %. Conclusions: Evaluation of BMI in acute myeloid leukemia patients before starting chemotherapy is is a respectable prognostic markers in assuming consequences in adult patients on induction chemotherapy.