Immunoglobulin replacement therapy (IgRT) is a cornerstone of treatment in patients with primary immunodeficiencies (PIDs), helping to prevent infections, control immune dysregulation, reduce organ damage, and improve quality of life. However, determining treatment indications, selecting the most appropriate product, adjusting doses, and managing treatment-related adverse effects remain important challenges in clinical practice. In this meeting, we will review the indications for IgRT, patient management strategies, and common clinical challenges in PIDs through case-based discussions. Practical approaches and real-life experiences on individualizing treatment for different patient groups will also be shared.