Bispecific antibodies (BsAbs) are emerging as important therapeutic options in relapsed multiple myeloma (MM). These agents target multiple antigens on plasma cells, such as BCMA, GPRC5D, and CD38, and engage T cells to kill MM cells. BsAbs have shown deep and durable responses in heavily pre-treated patients with a predictable safety profile and off-the-shelf availability. They are being studied as first-line options in newly diagnosed MM and are being optimized in the treatment algorithm. Current BsAbs include teclistamab, elranatamab, and talquetamab, which have shown significant efficacy in clinical trials. Teclistamab was approved by the FDA for RRMM patients with at least three prior lines of therapy, while elranatamab was approved for patients with at least four prior lines. Talquetamab received accelerated approval for RRMM patients with at least four prior lines. BsAbs also show promise in combination with other therapies, such as daratumumab and lenalidomide, to enhance efficacy. However, resistance mechanisms such as T-cell exhaustion, target antigen mutation, and high disease burden remain challenges. Strategies to overcome these include combining BsAbs with immunomodulators, gamma secretase inhibitors, and other agents. BsAbs are also being moved to earlier lines of therapy where T-cell fitness is better. Despite their efficacy, BsAbs can cause significant side effects, including infections, cytokine release syndrome, and neurological toxicity. The safety profile and side effects of BsAbs are being closely monitored, and strategies to mitigate these are being developed. Overall, BsAbs represent a promising new class of therapies for MM, with ongoing research aimed at improving their efficacy and safety.Bispecific antibodies (BsAbs) are emerging as important therapeutic options in relapsed multiple myeloma (MM). These agents target multiple antigens on plasma cells, such as BCMA, GPRC5D, and CD38, and engage T cells to kill MM cells. BsAbs have shown deep and durable responses in heavily pre-treated patients with a predictable safety profile and off-the-shelf availability. They are being studied as first-line options in newly diagnosed MM and are being optimized in the treatment algorithm. Current BsAbs include teclistamab, elranatamab, and talquetamab, which have shown significant efficacy in clinical trials. Teclistamab was approved by the FDA for RRMM patients with at least three prior lines of therapy, while elranatamab was approved for patients with at least four prior lines. Talquetamab received accelerated approval for RRMM patients with at least four prior lines. BsAbs also show promise in combination with other therapies, such as daratumumab and lenalidomide, to enhance efficacy. However, resistance mechanisms such as T-cell exhaustion, target antigen mutation, and high disease burden remain challenges. Strategies to overcome these include combining BsAbs with immunomodulators, gamma secretase inhibitors, and other agents. BsAbs are also being moved to earlier lines of therapy where T-cell fitness is better. Despite their efficacy, BsAbs can cause significant side effects, including infections, cytokine release syndrome, and neurological toxicity. The safety profile and side effects of BsAbs are being closely monitored, and strategies to mitigate these are being developed. Overall, BsAbs represent a promising new class of therapies for MM, with ongoing research aimed at improving their efficacy and safety.