The fourth joint inter-agency report (JIACRA IV) on antimicrobial consumption (AMC) and antimicrobial resistance (AMR) in bacteria from humans and food-producing animals in the EU/EEA (2019–2021) analyzed data from surveillance networks of the European Centre for Disease Prevention and Control (ECDC), European Food Safety Authority (EFSA), and European Medicines Agency (EMA). The report assessed AMC in humans (125.0 mg/kg biomass) and food-producing animals (92.6 mg/kg biomass), showing a 44% decrease in AMC in animals between 2014 and 2021, while human AMC remained stable. Statistical analyses revealed positive associations between antimicrobial use and resistance in bacteria from both humans and animals. For certain antimicrobials, statistically significant decreases in AMC and AMR were observed in several countries. The report highlights the effectiveness of measures to reduce AMC in food-producing animals and humans, but emphasizes the need for continued efforts to maintain reductions. It also underscores the importance of measures promoting human and animal health, such as vaccination and improved hygiene, to reduce antimicrobial use. The findings suggest that reducing AMC can lead to lower AMR in both humans and animals, but further research and action are needed to address the ongoing challenge of AMR.The fourth joint inter-agency report (JIACRA IV) on antimicrobial consumption (AMC) and antimicrobial resistance (AMR) in bacteria from humans and food-producing animals in the EU/EEA (2019–2021) analyzed data from surveillance networks of the European Centre for Disease Prevention and Control (ECDC), European Food Safety Authority (EFSA), and European Medicines Agency (EMA). The report assessed AMC in humans (125.0 mg/kg biomass) and food-producing animals (92.6 mg/kg biomass), showing a 44% decrease in AMC in animals between 2014 and 2021, while human AMC remained stable. Statistical analyses revealed positive associations between antimicrobial use and resistance in bacteria from both humans and animals. For certain antimicrobials, statistically significant decreases in AMC and AMR were observed in several countries. The report highlights the effectiveness of measures to reduce AMC in food-producing animals and humans, but emphasizes the need for continued efforts to maintain reductions. It also underscores the importance of measures promoting human and animal health, such as vaccination and improved hygiene, to reduce antimicrobial use. The findings suggest that reducing AMC can lead to lower AMR in both humans and animals, but further research and action are needed to address the ongoing challenge of AMR.