The dramatic improvement in outcome for children with acute lymphoblastic leukemia is one of the major achievements in hematology in the last 40 years. However, while 90% of children with this disease can now be cured, the outlook has not been so good for the less common type of childhood leukemia, acute myeloid leukemia (AML). Although only 1 in 7 children with leukemia have AML, half of these children will die from their disease. The challenge now is to harness the new developments in genomics to improve the outcome for these children.