Objective: The Tower of London (TOL) is a measure of executive functioning (EF), specifically planning. Visuospatial functioning (VS) is correlated with, and predictive of, performance on the TOL in adults. Neurocognitive effects of pediatric acute lymphoblastic leukemia (ALL) may include VS deficits. The objective of this study was to investigate the extent to which VS was related to, and possibly predictive of, TOL performance in youth diagnosed with ALL. Method: Participants included 45 ALL patients aged 6-18 (74% males) who underwent neuropsychological evaluation following cancer treatment. Data were collected from evaluations conducted as part of routine care through a survivorship clinic at a medical university. Pearson correlations and regression analyses were conducted to determine the extent to which measures of VS predicted performance on a computerized version of the TOL. Measures of VS included WISC-III Block Design, Beery Visual-Motor Integration, and Judgment of Line Orientation. Results: Block Design and Judgment of Line Orientation were significantly correlated with TOL performance (all ps < .05), Beery VMI was not (p > .05). VS significantly predicted TOL performance and explained 31% of the variance in planning. Judgment of Line Orientation, a measure of visuospatial perception, was a significant predictor (β = -.39, p = .024, CI = -5.13 to -.39). Conclusion: In neuropsychological assessment of children with ALL, it may be important to assess VS when utilizing the TOL because of the potential mediating effects of VS, particularly visuospatial perception, on performance for this task.