Acute lymphoblastic leukaemia (ALL) is rare in patients over 60 years of age, but because of the ageing of population in western countries, it could become an increasing problem in the coming years. Until now, only a few studies on the treatment of ALL in these patients have been published, with discouraging results. In fact, while in adult patients with ALL complete remission rates are about 90%, with a median overall survival time of 2 years, for elderly patients (> 60 years) the remission rate is below 70%, with a median overall survival of 7 months. Here we review the results of the literature, both in retrospective series and in prospective studies, concentrating on characteristics and treatment of elderly ALL patients, summarizing which factors have a prognostic relevance, and which are the therapeutic options in the treatment of this disease. Altogether, data on 514 patients with ALL > 55 years have been reported in the literature in 12 reports from 1990 to 2001.