Relapsed or refractory follicular lymphoma remains a significant clinical challenge even after 2020. Some patients have early progression or are resistant to treatment based on anti-CD20 antibodies, which worsens their outlook. As of 2020, immunotherapy has been approved as a third-line treatment for this type of lymphoma. The combination of lenalidomide and rituximab is a well-established, chemotherapy-naïve treatment option and is recommended in international guidelines. However, in high-risk patients, the results of this combination remain unsatisfactory. These findings highlight the need for new, more effective therapeutic strategies for relapsed or refractory follicular lymphoma.