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We report the case of a 32-year-old patient who presented to our Department in May 2016 for respiratory symptoms (cough, dyspnea) and fever. The tomographic evaluation revealed a large mass in the mediastinum and numerous pulmonary nodules. A pulmonary biopsy established the diagnosis of classic Hodgkin's lymphoma - nodular sclerosis, stage IVB. After six courses of BEACOPP, the complete response was obtained. Two months later, he was admitted for cough and fever; the X-ray evaluation revealed new pulmonary mass in right lung lobe, and a new biopsy confirmed the disease relapse. Chemotherapy was reinitiated with one course of DHAP followed by five courses of brentuximab. Immediately after the second complete response was obtained (PET-CT negative), the autologous transplantation of haemopoietic stem cells (ASCT) was performed. Few months after ASCT, PET-CT evaluation follwed by pulmonary biopsy confirmed the early relapse of disease despite chemotherapy with brentuximab. We initiated another chemotherapy protocol with six courses of GVD, but with no response at the tomographic reevaluation. Allogeneic transplantation was considered, but there was no suitable donor available. We decided to introduce immunotherapy with nivolumab, an anti-PD-1 antibody, which induced a significant improvement in interim PET-CT after seven courses. In this case report, nivolumab was an effective treatment in refractory relapsed Hodgkin lymphoma. [ABSTRACT FROM AUTHOR]