The depot formulation of liposomal cytarabine (DepoCyte) has proven to be useful as intrathecal (IT) treatment of neoplastic and lymphomatous meningitis. We report the results of compassionate use of DepoCyte in 6 patients diagnosed with acute leukemia (AL) and CNS involvement. Two patients had CNS involvement at diagnosis and the remaining 4 had CNS relapse. Three patients received DepoCyte as adjuvant therapy and achieved complete response whereas 2 out of the remaining 3 cases treated with DepoCyte as the only drug showed sustained response. The side effects were mild and manageable in all patients. These findings justify the development of clinical trials to evaluate the efficacy and safety of IT depot cytarabine in meningeal involvement of AL.