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Background: Recent studies have shown the trends in children cancer types, its frequencies, and mortality in some areas of the world. The aim of this study was to analyze the pattern of childhood cancer in a university affiliated hospital for the first time in Sari in a period of 10 years (2001-2010) and to compare the results with similar reports. Methods: This descriptive retrospective study includes all the consecutive pathologically or cytologically proved childhood cancer cases diagnosed in Avicenna Hospital from 2001 to 2010. Malignancies were grouped according to the third international classification of childhood cancer. The frequencies of each type of cancer cases were determined by three age groups (0-4, 5-9, 10-14 years) and gender. The patients’ job and home residency were noted. Results: We found 148 cases of cancer among 0-14 year old children with the boy/girl ratio of 1.24. The highest frequency was seen in 5-9 year age group. The most frequent childhood cancers were leukemias (30.5%) followed by lymphomas (16.4%), carcinomas and melanoma (14.5%), and soft tissue sarcomas (9.5%). Fifty four percent of the patients were urban. A gradual increase in the number of new diagnosed cases was observed per year. Conclusion: The two most common childhood cancers diagnosed during this study were leukemias and lymphomas consistent with reported series from other Asian countries and similar to that of Latin America. The third most common one was distinct with respect to the apparently higher frequency of carcinomas.