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Of all the paediatric malignancies, lymphomas account for about 10-15% of the cases with half of them diagnosed as Hodgkin's lymphoma. With a 5-year survival rate approaching 95%, a high index of suspicion is necessary to diagnose Hodgkin's lymphoma at an early stage, since many children in the developing countries present with an advanced stage. We report a typical case of classical Hodgkin's lymphoma, mixed cellularity subtype in a 10-year old girl with early-stage unfavourable disease presenting as a slightly painful right cervical mass and "B" symptoms. Erythrocyte sedimentation rate (ESR) was elevated. Ultrasound neck scan suggested tuberculous lymphadenitis. Other laboratory and radiological findings were normal. Fine needle aspiration smears and histopathology helped in arriving at diagnosis of classical Hodgkin's lymphoma, mixed cellularity subtype. The child was treated with a combination of combined chemotherapy and radiotherapy. KEYWORDS: Hodgkin's lymphoma; children; early-stage unfavourable disease; mixed cellularity subtype BACKGROUND: Of all the paediatric malignancies, lymphomas account for about 10-15% of the cases 1 with half of them diagnosed as Hodgkin's lymphoma 2 . Remarkably, this malignancy has a high cure rate with a 5-year survival rate approaching 95% 1. Hodgkin's lymphoma has an overall incidence rate of 14 per 100, 000 under 15 years of age. It has a typical bimodal distribution with respect to age. In developed countries, the peak incidence is seen in the young adults and elderly. While, in developing countries the incidence is higher among children and young adults with a male preponderance. Histologically, mixed cellularity subtype of classical Hodgkin's lymphoma occurs commonly in the children and in developing countries 3 . We report a typical case of classical Hodgkin's lymphoma, mixed cellularity subtype in a 10-year old girl with early-stage unfavourable disease presenting as a slightly painful right cervical mass and "B" symptoms.