Background: This hematological malignancy comprises a major health problem in the society due to its high mortality and morbidity. There is a need for the accurate estimation of incidence and prevalence of acute lymphocytic leukemia (ALL), and other hematological malignancies in India to estimate the true disease burden and its impact on the population which may help in formulating the guideline which helps in better risk stratification and treatment. Unfortunately, there is a real paucity if epidemiologic data on pediatric cancers in India and particularly in several parts of Gujarat. Objectives: To find out the prevalence and other epidemiological distribution of hematological malignancy in pediatric age group patients. Furthermore, it was objected to study hematological profile and bone marrow typing in pediatric patients with hematological malignancies. Methodology: A prospective observational study carried out over 2½ years. Confirm cases of hematological malignancies were recruited from the pediatric outpatient and inpatient department. Data recorded in the preformed case record form include demographic data, data of clinical history and clinical examination, laboratory findings such as complete blood count, peripheral smear examinations, bone marrow examination for cellularity and differential count, and immunophenotyping. Fine needle aspiration cytology or biopsy of lymph node was done in suspected lymphoma patients. Observations: ALL is the most common hematological malignancy among pediatric patients in the present study with 122 out of 158 patients (77.21%). Other malignancies are acute myeloid leukemia (AML) (13.29%) and chronic myeloid leukemia (2.59%) and lymphoma (5.69%). Nearly half of the patients were below 5 years of age (51.26%) and males were predominantly affected with frequency of 77.6%. Common clinical features were fatigue, fever, loss of appetite, bone pain, petechies, hepatic and splenomegaly, pallor, and lymphadenopathy. In ALL, most common blast type in bone marrow was L1 type (86.44%), whereas in AML, it is M2 type (80%). Conclusion: The most common type of malignancies in pediatric age group is hematological malignancies with predominant variant is ALL. It is commonly affecting age below 5 years with male predominance.