The genomic analysis of acute lymphoblastic leukemia (ALL) is providing novel insights into the disease, which will inform and direct treatment decisions and research. The 1st International Workshop on Acute Leukemias (iwAL), held in St. Pete Beach, FL, hosted a session focusing on the genomic landscape of ALL, which is ever-changing. In this panel discussion, Charles Mullighan, MD, MBBS, and Kathryn Roberts, PhD, both from St. Jude Children's Research Hospital, Memphis, TN, are joined by Anjali Advani, MD, of Case Western Reserve University, Cleveland, OH. The experts discuss the main points from Dr Mullighans talk on the genomic landscape of ALL in children and adults, which highlights the need to continually update our classification of subtypes. This informative discussion concludes with the group considering the future implementation of molecular profiling, minimal residual disease (MRD) and novel targeted approaches for ALL.