Bispecific antibodies (BsAbs) and CAR-T cells are two promising immunotherapies for diffuse large B-cell lymphoma (DLBCL). CAR-T cells, specifically CD19-directed therapies, have shown significant efficacy in relapsed/refractory DLBCL, with long-term survival rates of 30–40%. However, their use is limited by logistical challenges, high costs, and severe side effects. BsAbs, which activate T-cells to target B-cells, offer a safer and more accessible alternative, with approvals for DLBCL in 2023. They have similar efficacy to CAR-T but with fewer side effects and can be administered in community settings. While BsAbs have not yet shown clear curative potential, they are being tested in combination with CAR-T and as frontline therapies. Recent approvals of epcoritamab and glofitamab have expanded treatment options for DLBCL patients. BsAbs are also being explored in combination with other therapies, including polatuzumab, and may play a role in future treatment strategies. Despite their advantages, BsAbs are not yet as effective as CAR-T in all cases, and further research is needed to determine their role in the treatment landscape. The future of DLBCL treatment may involve a combination of both therapies, with ongoing studies evaluating their efficacy and safety. Cost and accessibility remain important considerations, with BsAbs generally being more affordable than CAR-T. As research continues, the optimal sequencing and use of BsAbs and CAR-T in DLBCL treatment will become clearer.Bispecific antibodies (BsAbs) and CAR-T cells are two promising immunotherapies for diffuse large B-cell lymphoma (DLBCL). CAR-T cells, specifically CD19-directed therapies, have shown significant efficacy in relapsed/refractory DLBCL, with long-term survival rates of 30–40%. However, their use is limited by logistical challenges, high costs, and severe side effects. BsAbs, which activate T-cells to target B-cells, offer a safer and more accessible alternative, with approvals for DLBCL in 2023. They have similar efficacy to CAR-T but with fewer side effects and can be administered in community settings. While BsAbs have not yet shown clear curative potential, they are being tested in combination with CAR-T and as frontline therapies. Recent approvals of epcoritamab and glofitamab have expanded treatment options for DLBCL patients. BsAbs are also being explored in combination with other therapies, including polatuzumab, and may play a role in future treatment strategies. Despite their advantages, BsAbs are not yet as effective as CAR-T in all cases, and further research is needed to determine their role in the treatment landscape. The future of DLBCL treatment may involve a combination of both therapies, with ongoing studies evaluating their efficacy and safety. Cost and accessibility remain important considerations, with BsAbs generally being more affordable than CAR-T. As research continues, the optimal sequencing and use of BsAbs and CAR-T in DLBCL treatment will become clearer.