Abstract: Diffuse large B-cell lymphoma (DLBCL) is more common in the elderly, who often exhibit a poor treatment response, more adverse reactions to chemotherapy, and significant inter-individual differences. There is currently no optimal treatment regimen, and the overall prognosis for elderly patients with DLBCL is poor. The R-CHOP regimen (consisting of rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisone) is the standard first-line therapy for DLBCL; however, some elderly patients find it difficult to tolerate. Various treatment plans to date have been explored for this specific group, including reducing R-CHOP use, combining R-CHOP with novel drugs, or utilizing new drug combinations. These approaches have achieved varying degrees of success. As the number of treatment options increases, individualized therapy is chosen according to patient age, general physical condition, and comorbidities as well as pathological characteristics of the disease. The key to improving prognosis lies in the early selection of an appropriate treatment plan to enhance remission and reduce recurrence rates.