Certain chemicals in hair dyes are known animal carcinogens. Darker, more permanent, and earlier dye formulations may be more carcinogenic than other dye types. For 769 adult acute leukemia cases and 623 population-based controls in a US and Canadian case-control study in 1986–1989, the authors asked separately about use of permanent and nonpermanent (semipermanent and temporary) hair dye use. Use was reported by 45% of women and 6% of men. There was a modest positive association for ever use of permanent dyes (odds ratio=1.5, 95% confidence interval: 1.0, 2.1), which was stronger for long duration (15 or more years) of use (odds ratio=1.8, 95% confidence interval: 1.0, 3.1). The greatest odds ratio was for 15 or more years of using hair dyes up to six times per year (odds ratio=2.4, 95% confidence interval: 1.0, 5.8); the corresponding odds ratio for use six or more times a year was lower, suggesting the possibility of misclassification of dye type among frequent users, since nonpermanent dyes tend to be used more frequently than permanent dyes. Nonpermanent dyes were not associated with risk. Long duration of permanent dye use may have a larger impact on the risk of adult acute leukemia and other hematopoietic cancers than prior epidemiologic data suggest.