Patients with stage IV diffuse B-cell lymphoma can be treated with chemotherapy, which is less effective in some patients. Stage IV diffuse B-cell lymphoma is defined as diffuse, disseminated invasion of one or more extranodal organs with or without lymph node invasion. It is categorized into stage IVA and stage IVB. Stage IVA patients are mainly treated with chemotherapy-based regimens, in combination with targeted drugs, or with autologous or allogeneic hematopoietic stem cell transplantation. With proper comprehensive treatment and keeping good mood, diet and lifestyle during the treatment period, stage IVA lymphoma can achieve complete remission. For stage IVB patients, if there is only bone invasion, the treatment effect is relatively satisfactory, but complete remission cannot be achieved. If there is central invasion, liver invasion or lung invasion, the treatment effect is poor. Therefore, the treatment of diffuse B-cell lymphoma depends on the site of invasion and the type of pathology, and a part of patients can be cured after comprehensive treatment.