Abstract CD4+ chronic lymphocytic leukemia (CLL) represents an extremely rare example of phenotypic aberrancy within CLL. We present a case of an 86‐year‐old male veteran with a history of multiple comorbidities who was incidentally diagnosed with CD4+ CLL during a routine peripheral blood workup. This case highlights the diagnostic challenges and characteristic features of CD4+ CLL, including flow cytometric analysis, molecular, and fluorescence in situ hybridization findings. The patient was classified as asymptomatic CLL Rai stage 0, warranting regular monitoring without a need for treatment intervention.
