Charles Mullighan, MBBS (Hons), MSc, MD, from St. Jude Childrens Research Hospital, Memphis, TN, provides an overview of his talk presented at the 2018 European School of Hematology (ESH) Clinical Updates on Acute Leukemias, held in Budapest, Hungary, where he discussed the advancements in the molecular classifications of acute lymphoblastic leukemia (ALL) with an increased understanding of the genetic drivers of the disease. The identification of the complex mutations that accompany the different subtypes of ALL have also allowed for a better prognosis for both childhood and adult ALL, as available therapies can be tailored to the patient.