Peripheral T-cell lymphoma (PTCL) is a highly aggressive subtype of non-Hodgkin lymphoma with poor prognosis and limited efficacy of conventional chemotherapy, while significant heterogeneity in survival benefits exists among its subtypes. In recent years, advances in understanding the molecular pathological mechanisms and tumor microenvironment of PTCL have led to emerging therapeutic options, including targeted therapies, immunotherapies, and novel combination strategies. In first-line treatment, the standard regimen of CD30-targeted antibody-drug conjugate brentuximab vedotin combined with chemotherapy (BV-CHP) has demonstrated improved outcomes. Further enhancements in efficacy have been achieved by integrating epigenetic agents (e.g., HDAC inhibitors) or exploring chemotherapy-free regimens. For post-remission maintenance therapy, agents such as JAK inhibitors, HDAC inhibitors, and immunomodulatory drugs have shown potential to prolong remission duration, reduce relapse risk, and improve survival outcomes. In relapsed/refractory PTCL settings, novel targeted therapies (e.g., PI3K/JAK inhibitors) and immunotherapeutic approaches (CAR-T cells, bispecific antibodies) have exhibited promising clinical activity. Moving forward, PTCL management is evolving toward precision medicine and multimodal strategies, with prospects for further survival improvements. This review summarizes recent advancements in PTCL therapeutics over the past three years, providing evidence-based references for clinical practice.