Background: Bone marrow examination is an important tool in diagnosing and controlling hematological disorders. Bone marrow aspiration and trephine biopsy are compatible. Thus; compiled the current study to evaluate and compare the effectiveness of bone marrow aspiration, imprint and biopsy in patients with acute leukemia. Materials& Methods: The present study was conducted in 50 clinically suspected patients of leukemia who attended inpatient and outpatient department of medicine, department of general pathology at SMS Medical College and Hospital, Jaipur, Rajasthan, India over a period of one year. All Patients with leukemia who underwent both bone marrow aspiration and bone marrow trephine biopsy examination were included in the present study. We analyzed all the results by SPSS software. One way ANOVA was used for assessment of level of significance. P- value of less than 0.05 was taken as significant.