Three-way Philadelphia (Ph) variant translocation is rarely found in patients with acute lymphoblastic leukemia. We report a 3-way Ph variant t(1;9;22)(p22;q34;q11.2) which was detected for the first time in acute lymphoblastic leukemia and a combined novel variant t(1;15)(q11;q24). The patient was a 56-year-old woman and was diagnosed with acute lymphoblastic leukemia. Karyotypic analysis showed 46,XX, t(1;9;22)(p22;q34;q11.2),der(15)t(1;15)(q11;q24). t(1;9;22)(p22;q34;q11.2) was reported only in patient with chronic myelogenous leukemia. Additional FISH showed 1q trisomy and supported the accurate detection of der(15)t(1;15)(q11;q24). Further studies are necessary to discover genes involved in development of the novel variant and the significance of the novel variant.