The review discusses the role of dual blockade immunotherapy targeting PD-1/PD-L1 and CTLA-4 in treating lung cancer. This approach, which combines the effects of immune checkpoint inhibitors (ICIs), has shown promise in enhancing immune responses against cancer cells by operating at different stages of T cell activation. Compared to monotherapy, dual blockade immunotherapy offers synergistic benefits, potentially improving efficacy while reducing treatment-related adverse reactions. Preclinical studies and clinical trials have demonstrated the effectiveness of dual ICI combination therapy, particularly in advanced non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). The review highlights the mechanisms of action, including the restoration of T cell activation and the enhancement of immune responses. Additionally, it explores the emergence and advancements of bispecific antibodies (bsAbs) in cancer therapy, which can target multiple immune inhibitory checkpoints and reduce toxicity. The review also discusses the safety and limitations of dual ICI combination therapy, noting the increased risk of treatment-related adverse events (TRAEs) and the need for careful dosing. Overall, the dual blockade immunotherapy and bsAbs represent promising strategies for improving the treatment of lung cancer, with ongoing clinical trials evaluating their efficacy and safety in various patient populations.The review discusses the role of dual blockade immunotherapy targeting PD-1/PD-L1 and CTLA-4 in treating lung cancer. This approach, which combines the effects of immune checkpoint inhibitors (ICIs), has shown promise in enhancing immune responses against cancer cells by operating at different stages of T cell activation. Compared to monotherapy, dual blockade immunotherapy offers synergistic benefits, potentially improving efficacy while reducing treatment-related adverse reactions. Preclinical studies and clinical trials have demonstrated the effectiveness of dual ICI combination therapy, particularly in advanced non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). The review highlights the mechanisms of action, including the restoration of T cell activation and the enhancement of immune responses. Additionally, it explores the emergence and advancements of bispecific antibodies (bsAbs) in cancer therapy, which can target multiple immune inhibitory checkpoints and reduce toxicity. The review also discusses the safety and limitations of dual ICI combination therapy, noting the increased risk of treatment-related adverse events (TRAEs) and the need for careful dosing. Overall, the dual blockade immunotherapy and bsAbs represent promising strategies for improving the treatment of lung cancer, with ongoing clinical trials evaluating their efficacy and safety in various patient populations.