Mantle cell lymphoma (MCL) is an uncommon subtype of lymphoma. In his latest review, co-authored with leading mantle cell lymphoma experts Dr Toby Eyre from Oxford and Prof Michael Wang from MD Anderson Cancer Centre, Prof Cheah discusses the key therapeutic approaches in the management of patients with relapsed MCL, covering in depth the data supporting the use of covalent Bruton tyrosine kinase (BTK) inhibitors at first or subsequent relapse. They describe the outcomes of patients progressing through BTK inhibitors, discuss mechanisms of covalent BTKi-resistance and treatment options post-covalent BTKi treatment. Options in this setting may depend on treatment availability, patient and physician preference, and patient age and comorbidity status. They discuss the state-of-the-art treatment options for patients in this setting.