The Bruton's tyrosine kinase (BTK) gene encodes a non-receptor tyrosine kinase that plays a critical role in B-cell development, activation, and signaling. Mutations in BTK can lead to impaired B-cell function and are associated with various hematologic malignancies, including chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL). One of the most clinically significant mutations is the C481F substitution in the BTK protein. This mutation occurs at cysteine residue 481, which is located within the ATP-binding pocket of BTK. The C481F mutation confers resistance to ibrutinib, a potent and selective inhibitor of BTK widely used in the treatment of B-cell malignancies. This resistance arises because the mutant cysteine is replaced by phenylalanine, disrupting the covalent binding between ibrutinib and BTK. Consequently, patients harboring this mutation may experience disease progression despite ibrutinib therapy. Understanding the molecular mechanisms underlying this resistance is crucial for developing alternative therapeutic strategies.