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The patients with leukemia have a high risk of venous thromboembolism and rarely, multiple bone sites can be involved to present as multifocal osteomyelitis. A four year old child had cellulitis, multifocal osteomyelitis, left pneumonia with pleural effusion, cervical lymphadenopathy, hepatomegaly and left internal jugular vein thrombosis, finally diagnosed as acute myeloid leukemia. A timely bone marrow biopsy study should be considered in a child with deep vein thrombosis along with multifocal osteomyelitis to diagnose and intervene acute myeloid leukemia early.