Background: Acute leukemias are treated with intensive chemotherapy protocols which are associated with increased risk of infections. The objective of this study was to determine the incidence of febrile neutropenia and sepsis in acute leukemia patients during induction chemotherapy.Methods: In this prospective study we analysed the data of febrile neutropenia of forty-four patients of acute leukemia treated with intensive chemotherapy protocols. Study was conducted in hemato-oncology unit of Government Medical College, Kozhikode from January 2018 to December 2018. Events of the first month of induction were assessed, data entered in Microsoft excel and analysed with SPSS software.Results: Febrile neutropenia developed in all patients with AML induction therapy and 21.4% patients with ALL induction therapy. Causative organism was identified in 41.6% of febrile neutropenia episodes. Major focus of infection was lower respiratory tract followed by gastrointestinal tract. Fungal infection was identified in 6.8% cases. Mortality in AML induction was 31% and that of ALL induction was 3.57%. Infection was the most common cause of mortality. No clinical or laboratory parameters were found significant to predict outcome during induction chemotherapy in acute leukemia.Conclusions: Neutropenic fever and sepsis are the major cause of mortality in acute leukemia during induction chemotherapy. Early initiation of appropriate antibiotics will help to improve outcome in the treatment of leukemia.