The cardiomyopthy associated with Adriamycin is frequently fatal and full clinical recovery is uncommon. To evalusate the radiological manifestation and the outcome of Adriamycin induced cardiac toxicity, wer retrospectively reviewed the serial chest X-ray films of children treated with Adriamycin. Among 154 children with leukemia, fourteen patients developed clinical and radiologic evidence of congestive heart failure(CHF). Six out of 14(43%) died of CHF within 2 weeks after attack and eight children survied after their acute eposodes of CHF, were controlled following digoxin and diuretic therapy. Despite the improving clinical evidence of heart failure, the follow-up chest roentgenograms of there 8 children showed definite cardiomegaly as compared with the pre-treatment chest X-ray. Three children among 8 had minimal cardiomegaly and the remaining five children showed persistent, marked cardiomegaly during the period of 9.25 months follow up. In summary, when CHF develops du ing chemotherapy in leukemic children, the possibility of Adriamycin induced cardiac toxicity should be suspected. Our findings showed that persistence of cardiomegaly represented significant cardiomyopathy despite clinical improvement of CHF.