Bacground and objective: Pyrimidine 5’nucleotidase I and II activities of peripheral mononuclear cells were studied to evaluate their role in diagnosis, assessment of therapy and follow up of remission in acute leukaemias. Design and methods: Blood samples were obtained from 40 untreated patients with acute lymphoblastic and myeloid leukaemia and 40 healthy controls, before the therapy and after remission. The correlation between the activity of the enzymes and the efficacy of therapy were established. The enzyme activities were measured by High-Performance Liquid Chromatography (HPLC), using the method described by Amici. For statistical analysis, Mann-Whitney U, Kruskal-Wallis and Wilcoxon methods were used. Results: Before the therapy, Pyrimidine 5’nucleotidase I levels in the leukaemic group were found to be significantly elevated when compared to the control group (p<0.001). Also Pyrimidine 5’nucleotidase II levels were significantly elevated before the therapy and during remission (p<0.02 and p<0.001 respectively). The isoenzyme activities were compared in patients who were in remission, who did not respond to therapy and in patients who died during the therapy, but no significant difference was found. Interpretation and conclusions: We concluded that, Pyrimidine 5’nucleotidase I and II activities can be used as markers for diagnosis and follow up of remission in patients with acute leukaemia. But, they can not have predictive value for prognosis.