Chimeric antigen receptor-T (CAR-T) cell therapy has revolutionized cancer treatment, yet its application to autoimmune diseases remains in its infancy. In 2024, Professor Huji Xu and his colleagues achieved a groundbreaking milestone in allogeneic CD19-targeted CAR-T therapy in patients with severe myositis and systemic sclerosis. In this dialogue, Professor Xu elaborated on the rationale and development of allogeneic CAR-T therapy as a cost-effective, scalable alternative to autologous approaches. By utilizing multiplex genome-edited CD19-targeted CAR-T cells derived from healthy donors, his team aims to address critical challenges in manufacturing, accessibility, and long-term efficacy. Professor Xu also discussed strategies for cost reduction, regulatory hurdles, and the broader implications for immunotherapy. Drawing on his extensive experience, he envisions allogeneic CAR-T therapy emerging as a transformative treatment for autoimmune diseases, with the potential to achieve widespread accessibility and profound clinical impact.