["Psycho-Oncology, Volume 35, Issue 8, August 2026. ", "\nABSTRACT\n\nBackground\nAdolescents with cancer face unique psychological, social, and developmental challenges that are distinct from those faced by children and adults. While coping strategies influence psychological outcomes, the evidence is limited to high‐income countries. Minimal longitudinal data exist in low‐ and middle‐income contexts, where sociocultural factors may shape coping strategies differently.\n\n\nMethods\nWe conducted a longitudinal qualitative study of adolescents newly diagnosed with Acute Lymphoblastic Leukaemia (ALL) at a tertiary cancer centre in India. Thirty participants were purposively sampled and interviewed at baseline,3‐ and 6‐months after treatment initiation. The interviews were transcribed, translated, and analysed using thematic analysis.\n\n\nResults\nAmong the 30 participants, 93% were male, with a median age of 16.5 years. Coping strategies evolved over time, initially dominated by maladaptive mechanisms such as avoidance, distancing, and blaming. At 3 months, participants employed a combination of strategies, including avoidance, humour, religious coping, and support‐seeking. By 6 months, there was an increase in adaptive strategies, including acceptance, meaning‐making, and post‐traumatic growth. Gender differences emerged: females favoured religious coping and reported concerns about body image, while males preferred humour and fatalistic attributions.\n\n\nConclusion\nCoping in adolescents with ALL evolved during treatment, with an early reliance on maladaptive responses and a subsequent shift towards adaptive strategies. Gendered patterns reflect cultural and developmental contexts. These findings underscore the importance of culturally sensitive and developmentally tailored psychosocial interventions, including structured psychoeducation, fertility counselling, and identity‐focused support, to enhance resilience and improve psychosocial outcomes.\n\n"]