In recent years, the landscape in the treatment of haematological malignancies, including leukaemia, has rapidly evolved. Hematopoietic stem cell transplantation (HSCT) retains its prominent role in the treatment of leukaemia, but its application continues to be associated with high mortality and graft-versus-host disease (GVHD). Novel therapies like Antibody-drug conjugates (ADCs) have shown potent anti-leukaemia activity and survival benefits in patients, demonstrating their potential as effective agents. Despite these advancements, challenges such as toxicity and acquired resistance, still need to be addressed. This review describes the current state and future directions of HSCT and ADCs in leukaemia, emphasizing the potential of these innovative approaches to transform treatment paradigms and improve patient outcomes. We will explore the current clinical practices and ongoing studies on combining different therapies, crucial and evolving research areas aimed at maximizing efficacy while minimizing toxicity in the patients.