This study was aimed to investigate the mRNA expression levels of insulin-like growth factor-I receptor (IGF-IR) and insulin receptor (IR) in peripheral blood lymphocytes of childhood ALL and their relationship with clinical features. The expression levels of IR and IGF-IR in peripheral blood lymphocytes of ALL children and healthy children were analysed. Peripheral blood samples were obtained from 43 ALL patients and 14 healthy children. The mRNA expression of IGF-IR and IR was measured by RT-PCR. The results showed that IGF-IR was widely expressed on peripheral blood lymphocytes of ALL children and healthy controls, mRNA level of IGF-IR significantly increased in ALL children of newly diagnosed, relapsed and hyperglycemia groups (P = 0.000, P = 0.002 and P = 0.05)as compared with the normal control group. mRNA level of IGF-IR in CR group was significantly lower than that in newly diagnosed and relapsed groups (P = 0.000 and P = 0.018); mRNA level of IR in newly diagnosed and relapsed groups were significantly lower than that in the normal control group (P = 0.001 and P = 0.018). mRNA level of IR in CR group was significantly higher than that in newly diagnosed and relapsed groups (P = 0.000 and P = 0.001); mRNA levels of IGF-IR and IR correlated with the clinical stages of the disease, while they had no association with the sex, age and white blood cell counts at new diagnosis. It is concluded that IGF-IR positively correlates with the stages of the disease, indicating that IGF-IR plays a leading role in the proliferation of tumor cells, and its increased expression levels may reflect the malignant proliferation of ALL cells.