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T-cell acute lymphoblastic leukemias (T-ALL) account for 25% of adult ALL and 15% of pediatric ALL. Their prognosis, long considered more unfavorable than that of B-ALL, has improved significantly in recent years. However, a major challenge remains in this disease. Nearly 20% of patients will suffer a relapse, which is still associated with an extremely poor prognosis (less than 20% survival at 5 years.) While advances in molecular biology in recent years have led to the identification of a large number of potentially targetable alterations involved in T oncogenesis, the therapeutic arsenal for relapsed or refractory disease remains limited to date, and only a few innovative therapies have been developed. Unlike B-ALL, T-ALL has not benefited from the immunotherapy revolution, which has seen the development of bispecific antibodies and the advancement of chimeric antigen receptor T cells (CAR-T cells) for B hemopathies. There is therefore an urgent need to identify new therapeutic targets that will lead, in the short term, to the development of new therapies that are lacking in this disease. This review presents recent advances in the oncogenesis of T-ALL and discusses the potential therapeutic opportunities associated with them.