We report two adults with T-cell acute lymphoblastic leukemia (ALL). Cytogenetic studies at diagnosis with R banding showed a 46,XX,t(4;11)(q21;p15)/46,XX karyotype in one patient and 46,XY,t(1;4;11)(p32;q21;p15)/46,XY in the other. Fluorescence in situ hybridization with whole chromosome paints (WCP1, WCP4, and WCP11) confirmed the complex rearrangement in the latter patient. Only 10 T-cell ALL patients with the t(4;11)(q21;p15) have been described, all, but one of them, being over 15 years old. Although recurrent in T-cell ALL, its frequency appears to be very low; indeed, it has been identified in only 4 of 193 adults and in 1 of 734 children with T-cell ALL thus far reported in the literature.