Chronic lymphocytic leukemia (CLL) is a type of blood cancer common in elderly and may not require treatment immediately after diagnosis as even early treatment does not cure the disease and even without treatment patients survive many years. Treatment is started only when hemoglobin and platelets start decreasing, after ruling other causes. Other indication include presence of systemic symptoms like weight loss, recurrent infections, progressive lymph node causing symptoms, rapid lymphocyte doubling time. Newer drugs like ibrutinib, venetoclax are improving outcomes in poor prognostic 17p deletion patients also. Front line treatment is chemo immunotherapy with FCR or BR depending on patients general condition, age and kidney function.