BACKGROUND: Acute lymphoblastic leukemia (ALL) represents the largest group of pediatric malignancies. The high cure rate of childhood ALL represents one of the most remarkable success stories in the war against cancer. In a lower middle income country (LMIC) like the Philippines, we reviewed the 5-year survival in a tertiary referral center. OBJECTIVES: This study aims to determine the 5-year survival of childhood ALL at a tertiary referral center for childhood cancer. METHODOLOGY: Medical charts of newly diagnosed ALL ages 1 to 18 years old from January 2012 to December 2016 were reviewed. OUTCOME: A total of 435 subjects were included in the study. The 5-year overall survival (OS) and event free survival (EFS) were 65.3% and 62.8%, respectively. The 5-year OS for standard risk ALL was 68.8% and for high risk ALL was 50%. The 5-year OS for the remission group was 83.7% and for the relapse was 21.1%. Univariate and multivariate analysis showed that WBC count at diagnosis, risk classification, immunophenotyping, and relapse showed significant prognostic impact for mortality. CONCLUSION The 5-year OS and EFS were lower compared to developed countries but are comparable with other LMICs. The prognostic factors for relapse and mortality were compatible with the literature. Overall, the adopted treatment protocols for childhood ALL in this institution showed acceptable results.