The treatment landscape for multiple myeloma (MM) is evolving, with monoclonal antibodies, proteasome inhibitors (PIs), and immune modulators (IMiDs) significantly improving survival and outcomes. However, relapse remains a significant challenge. Bispecific antibodies (BsAbs) have emerged as promising therapeutic options, engaging T cells to target plasma cells through various antigens like BCMA, GPRC5D, and FcRH5. These agents have shown durable responses in heavily pretreated patients with manageable side effects and off-the-shelf availability. Ongoing research focuses on overcoming resistance mechanisms such as T cell exhaustion, target antigen mutation, and high disease burden. Trials are also exploringBsAbs as first-line treatments in newly diagnosed MM. Key targets include BCMA, GPRC5D, and FcRH5, each with unique advantages and clinical trials underway. Safety profiles include infections, cytopenias, cytokine release syndrome (CRS), and neurological toxicities, with strategies to mitigate these side effects being developed. The potential to moveBsAbs to earlier lines of therapy is being explored, leveraging better T cell function and immune milieu. Compared to other immune-based therapies, BsAbs offer advantages in availability, reliability, and reduced severe side effects. Optimal sequencing of immune-based treatments remains a critical area of research.The treatment landscape for multiple myeloma (MM) is evolving, with monoclonal antibodies, proteasome inhibitors (PIs), and immune modulators (IMiDs) significantly improving survival and outcomes. However, relapse remains a significant challenge. Bispecific antibodies (BsAbs) have emerged as promising therapeutic options, engaging T cells to target plasma cells through various antigens like BCMA, GPRC5D, and FcRH5. These agents have shown durable responses in heavily pretreated patients with manageable side effects and off-the-shelf availability. Ongoing research focuses on overcoming resistance mechanisms such as T cell exhaustion, target antigen mutation, and high disease burden. Trials are also exploringBsAbs as first-line treatments in newly diagnosed MM. Key targets include BCMA, GPRC5D, and FcRH5, each with unique advantages and clinical trials underway. Safety profiles include infections, cytopenias, cytokine release syndrome (CRS), and neurological toxicities, with strategies to mitigate these side effects being developed. The potential to moveBsAbs to earlier lines of therapy is being explored, leveraging better T cell function and immune milieu. Compared to other immune-based therapies, BsAbs offer advantages in availability, reliability, and reduced severe side effects. Optimal sequencing of immune-based treatments remains a critical area of research.