There are great differences in the clinical process and prognosis of the chronic lymphocytic leukemia(CLL), the precise diagnosis is of importance to judge prognosis, guide therapy and research pathogenesis mechanism. The variable region mutation of immunoglobulin heavy chain is the most stable molecular index of disease prediction. The patients with sequence of IgHV somatic high mutation usually have a better prognosis and a more longer survival time than those without the mutation. The recent study has found that specific IgHV gene expression also can predict the disease outcome in some cases regardless of mutation. The clinical prognosis of CLL patients can be further stratified by specific IgHV gene expression. In this review, the progress in the research of the clinical significance of specific IgHV gene expression in the chronic lymphocytic leukemia is summarized.