Abstract: An association of acute myeloid leukemia (AML) with a granuloma has seldom been reported in the literature. We report a case where 62-year old male, diagnosed as AML on the bone marrow had a co-incidental epithelioid granuloma. The work up for common causes such as tuberculosis and fungal elements were negative. This case raises a pertinent question on the simultaneous association between AML and granulomas. In the present case, the three follow-up has so far been uneventful.