Leukemia is the most common childhood malignancy and often presents with nonspecific symptoms. Occasionally, it presents with extramedullary manifestations, which have been more frequent in cases of myeloid lineage or T cells. However, precursor B-cell leukemia/lymphoblastic lymphoma can also have extramedullary manifestations in some patients. Describing certain clinical features along with diagnostic imaging can establish a presentation pattern and suggest a diagnosis in the pediatric population. Herein, we present a series of four patients with extramedullary manifestations of B-cell lymphoblastic leukemia, describing their clinical imaging and histopathological characteristics.