Background: Cytogenetic abnormalities are critical prognostic factors in acute myeloid leukemia (AML). This study aimed to analyze the cytogenetic profiles and risk stratification of AML patients in a tertiary care setting. Methods: This observational study was conducted at the Department of Haematology, BSMMU, Dhaka, from July 2015 to June 2016, involving 50 adult patients diagnosed with de novo AML. Cytogenetic analyses were performed to identify chromosomal abnormalities, and patients were stratified into favorable, intermediate, and adverse risk groups based on established cytogenetic criteria. Results: The age distribution shows that 22% of patients were under 30 years, 40% were between 30 and 50 years, and 38% were over 50 years. The gender distribution reveals a slight male predominance, with 56% of the patients being male and 44% female. The study identified t(8;21), inv(16), and t(15;17) as the most common cytogenetic abnormalities, accounting for 20%, 10%, and 14% of patients, respectively. Overall, 44% of patients were classified into the favorable risk group. Among the favorable group, 81.8% achieved complete remission, whereas the adverse group showed a significantly lower remission rate of 21.4%. The presence of monosomy 7 and complex karyotype was noted in 16% and 12% of patients, respectively. Conclusion: Cytogenetic analysis is essential for risk stratification in AML. The findings highlight the importance of specific chromosomal abnormalities in predicting treatment outcomes, emphasizing the need for personalized therapeutic strategies. Integrating cytogenetic evaluation into routine clinical practice can enhance the management of AML and improve patient care.