© 2016 Ferrata Storti Foundation. Achievement of complete remission is essential for long-term survival of acute myeloid leukemia patients. We evaluated the prognostic significance of cytogenetics at complete remission in 258 adults with de novo acute myeloid leukemia and abnormal pre-treatment karyotypes, treated on Cancer and Leukemia Group B front-line studies, with cytogenetic data at onset of morphological complete remission. Thirty-two patients had abnormal karyotypes at time of initial complete remission. Of these, 28 had at least 1 abnormality identified pre-treatment, and 4 acute myeloid leukemia-related abnormalities not detected pre-treatment. Two hundred and twenty-six patients had normal remission karyotypes. Patients with abnormal remission karyotypes were older (P<0. 001), had lower pre-treatment white blood counts (P=0. 002) and blood blast percentages (P=0. 004), were less often classified as Favorable and more often as Adverse among European LeukemiaNet Genetic Groups (P<0. 001), and had shorter disease-free survival (median 0. 6 vs. 0. 9 years; P<0. 001) and overall survival (median 1. 2 vs. 2. 2 years; P<0. 001) than patients with normal remission karyotypes. Sixteen patients with normal remission karyotypes also harbored nonclonal abnormalities unrelated to pre-treatment karyotypes. They had shorter overall survival than 210 patients with only normal metaphases (P=0. 04). Forty-eight patients with any clonal or non-clonal chromosome abnormality at complete remission had worse disease-free survival (median 0. 6 vs. 1. 0 years; P<0. 001) and overall survival (median 1. 2 vs. 2. 5 years; P<0. 001) than 210 patients with exclusively normal metaphases. In multivariable analyses, after adjustment for age, the presence of any remission abnormality was associated with shorter disease-free survival (P=0. 03) and overall survival (P=0. 01). We conclude that detection of any abnormality at complete remission is an adverse prognostic factor.