Acute lymphoblastic leukemia (ALL) is a hematological malignant disease originated from B or T cells. The occurrence and development of ALL are related to the bone marrow microenvironment, which is a complex network system, including osteoblasts, stromal cells, mesenchymal stem cells (MSC), adipose cells, macrophages and regulatory T cells (Treg). The abnormal bone marrow microenvironment formed by the changes of biological characteristics of these cells provides a suitable space for the growth and proliferation of ALL cells. To explore the effect of abnormal bone marrow microenvironment on the occurrence and development of ALL, this review summarizes the advances in the abnormal bone marrow microenvironment of patients with ALL, and interaction between the various related cells and ALL cells.