Primary mediastinal B-cell lymphoma (PMBCL) is aggressive B-cell lymphoma with unique clinicopathologic characteristics.However,under the new classification of PMBCL,whether R-CHOP was the standard first-line immunotherapy regimen remains a controversy.The DA-EPOCH-R is not inferior to R-CHOP,but attention should be paid to the toxic effects.PMBCL is a radiosensitive disease,but radiotherapy did not as the front-line therapy for PMBCL.A biopsy is required for positive PET/CT after immunotherapychemotherapy to determine the further treatment of PMBCL.Recurrent/refractory PMBCL,with poor prognosis,salvage immunochemotherapy is often used followed by high-dosechemotherapy and autologous stem celltransplant.PD-1 overexpression is common in recurrent/refractory PMBCL,and immune checkpoint inhibitors are potential to be an important treatment option.Recently,the development of molecular medicine has provided a new basis for the selection of targets in PMBCL,however,it needs to be further confirmed by clinical trials.