Abstract: Follicular lymphoma (FL) is a disease that features strong biological, clinical, and prognostic heterogeneity and is affected by various factors. The historically used prognostic factors such as those involved in the Follicular Lymphoma International Prognostic Index (FLIPI) and FLIPI-2, which are broadly based on clinical and laboratory features at the time of diagnosis, are of limited value. With the development of molecular imaging and gene sequencing technology, the prognostic value of the metabolic tumor burden parameters and molecular biological features (e.g., characteristics of the tumor microenvironment and epigenetic deregulation) in FL have been gradually recognized as promising, particularly in combination with the well-established clinically based prognostic indexes such as m7-FLIPI, a clinicogenetic risk model that includes the mutation status of seven genes. In addition to the baseline prognostic factors, the prognostic value of response to therapy has also been a hot topic in recent years. This review discusses the prognostic factors that affect patients with FL, referring to histological grade, metabolic tumor burden, clinically based prognostic indexes, tumor microenvironment, response to therapy, and molecular genetic characteristics, according to domestic and abroad research progress.