Chemotherapy-induced hepatotoxicity is a common cause of abnormal liver function test in patientsrnwith ALL. L-asparginas is a drug for ALL patients as induction therapy. The majority of adverserneffects are hypersensitivity reactions, but serious liver and other organ related injury may occur.rnIncidence rate and associated risk factors is not well document in our setting. rnObjective: To assess hepatotoxicity incidence and risk factors among adults and pediatrics ALLrnpatients on chemotherapy induction at Black Lion Specialized Hospital, Addis Ababa, Ethiopia fromrnJanuary 2019 â€“ September, 2019.rnMethodology: Hospital based prospective cohort study design was conducted from February 1,rn2019â€“ September 30, 2019 at BLSH hematology unit. A total of 40 admitted and consentingrnparticipants were included in the study using convenient sampling technique. A relevant clinical andrndemographic data and biochemical profile of liver function & pancreatic organ function tests wererncomputed using appropriate statistical tools. Descriptive statistics was used for most variables,rnrepeated measurement of ANOVA, paired T test and binary logistic regression was used to test thernassociation among various variables. P-value of < 0.05 was used as a measure of statisticalrnsignificance.rnResult : From the total (40) ALL cases, an overall increased level of serum AST, ALT, ALP, totalrnbilirubin, direct bilirubin, amylase, lipase was found in 16(40%), 18 (45%), 19(47.5%), 19(47.5%),rn27(67.5%) ,10(25%), and 9(22.5%) cases after induction therapy, respectively. The overallrnhepatotoxicity among all the subjects was5% (2/40). The mean value of serum alkaline phosphatase,rntotal bilirubin, and bilirubin direct were significantly increased in ALL patients after inductionrntherapy as compared with before induction therapy. After induction therapy blirubin total wasrnsignificantly associated with alcohol intake and ALP was significantly associated with weight loose. rnAST, ALT, blirubin direct, amylase and lipase were not associated with weight loose, alcohol intake,rnage, gender and blood transfusion.rnConclusion: The finding of this study concluded that chemotherapy drugs like L-asparginase,rnvincristine, Predensolon, Doxourobin and others cause significant alterations of clinical chemistryrntests like liver and pancreatic enzymes. These alterations could be contributed to liver and pancreaticrndysfunction on ALL patients. Patients more susceptible to hepatotoxicity such as those withrnmalnutrition or alcoholism should be followed up more closely. And also, pediatrics has acuternpancreatitis so they should have followed them more frequently.