Aim: To evaluate practice patterns of hematopoietic cell transplantation (HCT) for acutelymphoblasticleukemia. Materials & methods: We utilized the National Cancer Database to extract patient-level data of adults (aged 18–80 years) diagnosed with acute lymbhoblastic leukemia between 2003 and 2012. We performed multivariable logistic regression to determine variables associated with the use of HCT. Results:Out of a total of 11,871 patients, 12.7% received HCT. In a multivariate analysis, older age, male sex, higher Charlson co-morbidity score, nonacademic treatment center, poor education and Medicare/Medicaid or no insurance were associated with lower likelihood of receiving HCT. Conclusion: Our study demonstrates variations in the utilization of HCT based on socioeconomic and health system factors.