CD19 CAR-T cell therapy has emerged as a pioneering strategy for treating acute lymphoblastic leukemia (ALL). Despite its promising potential, investigator-initiated trials in this field have remained limited in Korea. This study represents the first instance of point-of-care treatment in a Korean hospital, where CD19 CAR-T cells were manufactured and directly administered to patients (NCT05210907). To improve therapeutic accessibility and efficacy, an automated closed system (Miltenyi Prodigy) was employed for cell production under Good Manufacturing Practice (GMP) standards. Unlike conventional commercial methods, CAR-T cells were directly administered without undergoing cryopreservation at doses of 0.2 to 5.0 x 10^6 CAR-positive viable T cells per kg body weight for patients weighing less than 50 kilograms, and 0.1 to 2.5 x 10^8 total CAR-positive viable T cells (non-weight-based) for patients exceeding 50 kilograms. Among the eight patients treated, six achieved successful outcomes, while two experienced CD19-negative relapse. The SNUH-CD19-CAR-T therapy demonstrated promising anti-leukemia activity, underscoring its effectiveness in ALL treatment. These findings are anticipated to drive future clinical research efforts and foster therapeutic advancements in the field.