Therapy of cancer with radiolabeled monoclonal antibodies has produced impressive results in preclinical experiments and in clinical trials conducted in radiosensitive malignancies, particularly B cell lymphomas. Two “first generation”, directly radiolabeled anti-CD20 antibodies, 131Iodine-tositumomab and 90Yttrium-ibritumomab tiuxetan were FDA-approved more than a decade ago, but have been little utilized due to a variety of medical, financial, and logistic obstacles. Newer technologies employing multi-step “pretargeting” methods, particularly those utilizing bispecific antibodies, have greatly enhanced the therapeutic efficacy of radioimmunotherapy (RIT) and diminished its toxicities. The dramatically improved therapeutic index of bispecific antibody pretargeting appears to be sufficiently compelling to justify human clinical trials and reinvigorate enthusiasm for RIT in the treatment of malignancies, particularly lymphomas.