Background: Hairy cell leukemia is a rare form of leukemia and has been rarely reported in African and pediatric population.
Observation: We are reporting a 4-year-old child who was received for investigation for persistent anemia, prolonged fever, and thrombocytopenia. Bone marrow aspiration showed hypercellular marrow with cells characterized by irregular windblown-appearing cell borders with pseudopod-like projections.