Diffuse large B cell lymphoma (DLBCL) represents the most common type of non-Hodgkin lymphoma (NHL) and it is a potentially curable disease with the current standard of care of immunochemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) especially the addition of rituximab. However, a relevant number of patients who acquire complete remission for 24 consecutive months have the potential for recurrence. Particularly, late recurrence (LR) defined as 5 years after the complete remission occurs with a much lower incidence. In this review, we present the recent data regarding the special clinical behaviors, histologic findings, proposed mechanisms, patterns of late relapse, and appropriate treatment options for patients with late relapse of DLBCL. Meanwhile, some useful suggestions that could be used in clinical treatments and clinical trial design are provided. Altogether, our study expands the knowledge of the special group related to late relapse.