Epstein-Barr virus (EBV) is a ubiquitous gammaherpesvirus that is associated with a variety of malignancies. Chronic active virus infection (CAEBV) is an EBV-associated T or NK cell lymphoproliferative diseases that occur most often in children and young adults in East Asia. It is still not known why this ubiquitous virus causes CAEBV in certain individuals. In this review, potential pathogenesis of CAEBV is thoroughly discussed. Recent advances in both basic and clinical research on CAEBV are also shown.