Richter’s transformation of chronic lymphocytic leukemia or nonHodgkin’s malignant lymphoma with a low grade of malignancy considerably alters the evolution and prognosis of the patient. There are clinical and biological factors that may suggest the risk of Richter’s transformation. We present the case of an elderly patient; the diagnosis of Richter’s syndrome was done simultaneously with that of follicular lymphoma. Initial complications and those which have occurred during treatment and the solutions chosen for overcoming them are discussed. Richter’s syndrome generally requires aggressive treatment, due to the presence of release risk, but it is important to take account of the age, performance status and concomitant diseases, like chronic lymphocytic leukemia behaviour, and as part of the personalization of the therapy.