Abstract: Tumor immunotherapy occupies a pivotal position in the field of hematological malignancies. Chimeric antigen receptor (CAR) T-cell therapy has established a new therapeutic pattern for hematological immunotherapy and achieved satisfactory clinical results in the treatment of B-lineage hematological malignancies. However, CAR T-cell therapy has some limitations in the treatment of T-cell acute lymphoblastic leukemia because of the presence of CAR T-cell fratricide, tumor cell contamination, T-cell aplasia, and other clinically relevant problems. Therefore, the current major challenge is overcoming the existing bottlenecks to optimize CAR-T therapy and improve its efficacy against T-ALL while improving the prognosis of patients.