In this case report we describe a case of acute myeloid leukemia (AML; FAB M4) diagnosed in a 27-year-old female at the 20th week of gestation. After informed consent, the patient chose to undergo anti-leukemic treatment without therapeutic abortion. Complete remission was obtained following standard chemotherapy for AML (doxorubicin, cytosin-arabinoside, 6-thioguanine). The patient successively underwent an autologous bone marrow transplant (ABMT). No fetal malformation was observed. Urgent cesarean section was necessary at the 29th gestational week because of the onset of foetal sufferance. Fourteen months after diagnosis and seven months after ABMT the patient died due to relapse of AML. The child is presently 3.5 year old and well. In our opinion, the care of a pregnant woman with acute leukemia is feasible and it needs a multi-specialist effort that is easier to be achieved in a tertiary care institution.