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Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia characterized by an abnormal proliferation of promyelocytes. It is often associated with an aggressive clinical presentation involving complex coagulopathies including disseminated intravascular coagulation, with a significant risk of bleeding and/or thrombosis if treatment with all-trans-retinoic acid (ATRA) is not rapidly initiated. Here we present a unique case of APL which was isolated to femoral bone lesions, without definitive evidence of peripheral blood or bone marrow involvement, and without systemic sequelae.