This study aimed to detect the relationship between prenatal exposure to organophosphate and organo chlorine pesticides and development of translocation (8;21); in an Egyptian population between 2010-2012. Malathion, Diazinon, DDT, and Lindane were detected in meconium by gas chromatography-mass spectrometry (GC-MS). T (8; 21) was detected by RT-PCR on RNA extracted from cord blood. Thirty eight (20%) out of 190 of the cord blood samples were positive for t (8;21). Chi square tests were used to assess differences in the frequency of pesticide exposure in t (8;21) carriers vs. non carriers and the risk estimates were assessed using binary logistic regression. The frequency of prenatal Malathion exposure was61, and 36% in newborn t (8;21) carriers and non-carriers, respectively, (OR 2.78, 95%CI 1.34-5.77). The frequency of exposure was 58 and 41% for Diazinon (OR 1.94, 95%CI 0.95-3.99), 79 and 51% for DDT (OR 3.55,) and 55 and 49% for Lindane (OR 1.32, 95%CI 0.63-2.66). Rural residents showed a higher frequency of translocation than the urban; 23.6% of the rural were carriers versus only 3%forthe urban, (P=0.007). Rural residents showed a 10 fold increased risk to develop the fusion Oncogene. Prenatal exposure to organophosphate and organochlorine is potentially related to the generation of t (8;21) in the cord blood of apparently healthy newborns. Residing in rural areas imparts a higher risk for carrying such translocation.Keywords: prenatal, organophosphate, organochlorine, gc-ms, leukemia, translocation (8;21) MOJ Toxicology Research Article Open AccessIn utero pesticides exposure and generation of acute myeloid leukemia associated translocation (8; 21)