Purpose Breast implant associated large cell lymphoma (BIA-ALCL) is a recognised non-Hodgkin lymphoma that was first described in 1997. The incidence has increased, owing largely to the increased profiling and subsequent recalling of many textured implants. Guidelines around this are targeted towards cis-women and historically the unique needs of transgender patients are overlooked. This review aims to determine the presentation and outcomes in transgender women and if there are specific recommendations for transgender women. Methods PUBMED, MEDLINE and SCOPUS databases were queried with the keywords of ‘transgender’, ‘implant’, ‘breast’ and ‘lymphoma’. All publications with English translations from inception were included. All abstracts were reviewed to decide upon inclusion. Results 76 articles were reviewed and 5 cases of BIA-ALCL were reported. A systematic review of 95 women with BIA-ALCL was used for comparison. The mean age at diagnosis was younger for transgender women at 45 compared to 52. The time between implant placement and diagnosis was comparable; 11 years versus 11.12 years. Seroma and/ or mass were the most common presenting symptom in both groups. Transgender were more likely to require chemotherapy in addition to surgery. Transgender follow up was almost half that of cis-women (12.8 months against 23.5 months). Conclusions Transgender women are diagnosed at a younger age, but their presentation is similar to that of cis-women. The higher percentage requiring chemotherapy suggests a more advanced stage of disease in transgender and the lack of follow up suggests disparity between these groups.