Pseudo Chediak-Higashi (PCH) granules are mainly common in acute myeloid leukemia. Here we found a patient diagnosed with common-B acute lymphoblastic leukemia(ALL) with PCH cytoplasmic granules, which was rarely seen in daily diagnosis. The morphology of the granules is different in transmission electron microscope (TEM) from cases reported before. There is a vesicle with various-sized particles surrounding the nucleus, in addition to the particles, a multiple-layer membrane structure was also detected in the vesicle.