Respiratory infections are a common cause of cytopenia in pediatric cancer patients undergoing treatment, with rhinovirus being the most frequent culprit. We aimed to assess the impact of rhinovirus infections during low-intensity chemotherapy maintenance in children with acute lymphoblastic leukemia (ALL). Clinical characteristics and outcomes of patients infected with rhinovirus between 2011-2021 were analyzed. Of the 207 patients on maintenance, 22% presented rhinovirus infection, with 50% experiencing associated cytopenia leading to treatment interruptions in 37%. No increase in relapses or mortality was observed. These findings suggest that rhinovirus infections can cause bone marrow toxicity during maintenance phase of ALL. Thus, the screening for rhinovirus infection should be considered as part of the investigation in cases of unexpected pancytopenia.