The t(15;17)(q22;q21), resulting in PML-RARA fusion gene, is a characteristic chromosomal translocation in acute promyelocytic leukemia (APL). We report a pediatric APL case with a 3-way translocation: t(5;17;15)(q35;q21;q22). Complete blood cell counts of a 12-year-old girl, of pale appearance, showed pancytopenia with increased blasts. Morphology and immunophenotype of the leukemic cells were compatible with APL. Karyotype analysis showed t(5;17;15)(q35;q21;q22) and add(7)(q32). We detected the PML-RARA fusion gene by both reverse transcriptase-polymerase chain reaction and fluorescent in situ hybridization analysis. The patient underwent successful treatment with cytarabine with all-trans retinoic acid and anthracycline-based therapy.