Anaplastic lymphoma kinase ( ALK)-fusion sarcomas are rare, part of the emerging theoretically-targetable tyrosine-kinase RAS::MAPK-pathway fusion myopericytic-ovoid-sarcomas. We report our clinicopathologic and treatment experience with an ALK-fusion sarcoma. A novel ERC1-unaligned-ALK-fusion infiltrative nonmetastatic low-grade sarcoma of the right hand of a 15-month-old male was treated with crizotinib, an ALK tyrosine-kinase inhibitor as oral monotherapy, inducing complete radiographic and clinical resolution by 10 months and sustained response now 8 months after elective discontinuation. Crizotinib can successfully be used to treat unresectable novel ALK-fusion sarcomas.