Abstract
Cytomegalovirus (CMV) infection is a leading cause of morbidity and mortality among immunocompromised individuals, especially hematopoietic stem cell transplant and solid organ transplant recipients. In recent years, significant advances have transformed the approach to CMV prevention and therapy. This manuscript explores key evidence regarding antiviral prophylaxis, treatment strategies, resistance mechanisms, and the potential of immune-guided monitoring in transplant settings. The role of novel agents such as letermovir and maribavir is highlighted. These findings support personalized strategies that balance efficacy, toxicity, and resistance in managing CMV infection.