The preferentially expressed antigen of melanoma (PRAME) is a signifi cant target for monoclonal antibodies and an oncospecifi c marker known for its activity on all the tumor cell diff erentiation stages and its eliciting of a spontaneous T-cell response. Since PRAME protein is active in approximately every second patient with solid tumors and oncohematological diseases, anti-PRAME immunotherapy is very promising. In current review the mechanism of spontaneous immune response against PRAME is discussed as well as the role of this antigen in immunosurveillance. The review deals with the PRAME-specifi c T-cell genesis and risk assessment of immunotherapy directed against PRAME-positive cells. The risks and benefi ts of various immunotherapy approaches including the use of dendritic cell vaccines, PRAME vaccination, development of specifi c T-cells, and development of specifi c monoclonal antibodies were analysed. Possible causes of treatment failure are analysed, and methods of overcoming them are suggested. The literature search in the Pubmed, Scopus, and eLibrary databases, with the use of "PRAME" as a keyword was performed. Only publications related to various aspects of immunotherapy and anti-PRAME-specifi c agents were included in the review.