Myeloid Leukemia with Down Syndrome (ML-DS) is a unique entity of AML with superior treatment response and overall survival compared to children with AML. Despite all of it, ML-DS survival rates for children in low- and middle-income countries (LMICs) remain poor. We described three ML-DS cases, which were treated with vincristine, cytarabine and daunorubicin plus triple intrathecal drugs. All of our three patients successfully finished the treatment, with two patients were still complete remission until now, and one died two days after finishing the chemotherapy. ML-DS is treatable in our limited-resources setting in Manado, Indonesia.