Abstract: In recent years, the number of diagnosed therapy-related hematological neoplasms has increased. Compared to primary hematological neoplasms, therapy-related hematological neoplasms have a poorer prognosis and are a serious complication following the treatment of solid tumors. Clonal hematopoiesis of indeterminate potential (CHIP) is considered a relevant factor in the pathogenesis of therapy-related myeloid neoplasms (t-MNs), leading to an increased risk of t-MN by promoting driver gene mutations. The pathogenesis of therapy-related hematological neoplasms primarily involves alkylating agents, topoisomerase inhibitors, platinum agents, poly ADP-ribose polymerase (PARP) inhibitors, and radiotherapy. Currently, allogeneic stem cell transplantation remains the most effective therapeutic option. This review analyzes advances in the epidemiology, pathogenesis, related drugs, prognosis, and treatment of therapy-related hematological neoplasms.