Background/Aim: Evidence has shown that has both antitumor and pro-tumor effects in various types of leukemia. The current study aimed at investigating the contribution of IL-18 polymorphisms to the risk of childhood acute lymphocytic leukemia (ALL) in Taiwan. Materials and Methods: IL-18 promoter -656 (rs1946519), -607 (rs1946518), and -137 (rs187238) genotypes of 266 childhood ALL cases and 266 controls were determined by polymerase chain reaction-restriction fragment length polymorphism methodology. Results: The distributions of genotypic and allelic frequencies of IL-18 rs1946519, rs1946518 or rs187238, were not significantly different between childhood ALL cases and controls (all p>0.05). However, in the stratification analysis among the cases, IL-18 rs187238 GC and CC genotypes were associated with increased childhood ALL risk and shorter survival (OR=4. 19 and 2.93, p=0.0001 and 0.0250, respectively). No association was found with rs1946519 and rs1946518 (all p>0.05). Conclusion: IL-18 rs187238 GC and CC genotypes can serve as predictors for childhood ALL prognosis among Taiwanese. Validation in larger and various populations can greatly extend the feasibility of this novel predictor.Acute lymphoblastic leukemia (ALL) is a disease that arises from the uncontrolled proliferation of lymphoid progenitors (1, 2). Typically, ALL is the most prevailing pediatric hematologic malignancy and mainly attacks children aged 2-5 years old (3-5). Although the pathogenesis and etiology of childhood ALL remain largely unknown, it is widely believed that childhood ALL is caused by genetic variations and environmental factors (6, 7). Recently, lots of studies reported that subtle alterations in the inherited genome, single nucleotide polymorphisms (SNPs), may play a critical role in determining the personal susceptibility to childhood ALL (8-13). The genetic factors associated with childhood ALL are largely undefined, and further explorations of the roles of these factors in relation to childhood ALL are beneficial for early detection and prediction of the disease. Interleukin-18 (IL-18) was originally found in 1999 as a member of IL-1 cytokine family (14). It is secreted by various cells including T and B lymphocytes, monocytes, 5283