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A 4 year old girl’s bone marrow aspirate was received to exclude metastasis. She was a known case of Neuroblastoma diagnosed on a retroperitoneal mass biopsy.  The complete blood count showed anemia with a hemoglobin of 8.9g/dl, total leucocyte count (TLC) of 4680/µl and platelet count of 4,38,000/µl. There was no left shift or nucleated red cells in peripheral smear. The bone marrow aspirate smears showed all normal hemopoietic cells including erythroid cells, myeloid cells and megakaryocytes. There were a few small clusters of small round cells suggestive of metastases (Figure 1). However, bilateral bone marrow biopsies showed only normal hematopoietic elements with no evidence of involvement by a tumor except for a few crushed areas. Immunohistochemistry (IHC) for synaptophysin, chromogranin, S100 and Neuron specific enolase (NSE) was performed and did not reveal any tumor deposit. This is an exceptional case in which tumor metastasis was seen on bone marrow aspirate but not on biopsy possibly due to focal marrow involvement.