Background: In acute lymphoblastic leukemia (ALL) the bone marrow loses its ability in the differentiation and maturation of blood cells at different stages. Zinc and copper are important co-factors for several enzymes and play an important role in maintenance of DNA integrity. Changes in serum levels of zinc and copper have been found in lymphoproliferative disorders. In the present study, the aim was to compare serum levels of zinc, copper, vitamin D, and inflammatory markers after eight courses of chemotherapy. Methods: Participants of this study included 30 ALL patients in the age range of 15 to 65 years. A 10 mL blood sample was taken before and after eight courses of chemotherapy. The concentration of Zinc, Copper, hs-CRP, vitamin D and malondialdehyde (MDA) were measured. Results: There was a significant increase in serum zinc (121.7 ± 18.05 µg/dL before chemotherapy and 156.6 ± 25.00 µg/dL after chemotherapy) and a significant decrease in serum copper (661.9 ± 190.1 µg/dL before chemotherapy and 402.2 ± 93.5 µg/dL after chemotherapy) and a significant decrease in Malondialdehyde and serum vitamin D were observwd. Further, no significant differences were observed in hs-CRP after chemotherapy. Conclusion: Results showed that chemotherapy could decrease the burden of disease by increasing serum zinc and decreasing serum copper.