ABSTRACT Early-stage follicular lymphoma (FL) has traditionally been treated with involved-field radiotherapy (RT). Rituximab (R) is low-toxic, efficient systemic therapy for FL; but there are no data about its clinical impact in early FL. We retrospectively analyzed 93 patients with stage I-II indolent FL treated with RT (n=65), or RT+R (n=14) or with R alone (n=14). Median follow up was 5.0 years for RT patients, 2.8 years for the RT+R subgroup and 2.5 years for R patients. The complete response rate was 92%, 100% and 86% (ns) and the median PFS was 3.3 years, not reached, and 4.9 years (p.035) for the RT, RT+R and R arm, with no impact on overall survival. Rituximab combined with RT seems to give better results in terms of global FL control, but longer follow-up and prospective comparison are needed to verify these results.