Methotrexate and cytarabine are intrathecal chemotherapy agents for acute lymphoblastic leukaemia. We report a case of a paediatric patient with late onset CNS relapse of Pre-B acute lymphoblastic leukaemia who developed chemotherapy-induced myelopathy secondary to triple intrathecal chemotherapy (TIT) with its imaging findings. Imaging plays a role in localising abnormality within the spinal cord for diagnosis and aids clinicians to prevent further axonal damage by stopping the causative chemotherapeutic agents.