The prognosis of elderly (>60 years) patients with diffuse large B-cell lymphoma (DLBCL) is significantly worse compared with young patients, and there is currently no standard treatment. Elderly patients with DLBCL are highly heterogeneous, a stratification before treatment can help achieve precise medicine and improve outcome of them. R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin and prednisolone) is still the recommended treatment for fit elderly DLBCL patients; and for unfit or very old patients, chemotherapy of reduced dose or palliative treatments should be considered. Choices for relapsed or refractory patients are limited, and novel compounds or therapies that are well tolerated may have a good application prospect.