Background: Based upon interesting recent published findings, we characterize disparities in clinical characteristics, treatment patterns, and outcomes for African American (AA) patients with multiple myeloma (MM) using real-world (RW) data. Methods: A random sample of patients diagnosed with MM were selected from the COTA RW database for the retrospective analysis to be stratified by race, AA (n=395) and other (n=396). To adjust for differences in age and gender, case-control matching was performed. Patient characteristics and treatment patterns were summarized. A Cox proportional hazards model was used to evaluate the relationship between patient characteristics and time to stem cell transplant (SCT). Overall Survival (OS) was calculated using the Kaplan-Meier method. Results: Median time from diagnosis of active MM to start of first-line (1L) treatment was longer among AA as compared to the other cohort (23 vs. 17 days respectively, p=0.01); VRD was the most common 1L therapy (17.39% vs. 18.58% respectively). The percent of patients receiving SCT was similar across racial cohorts (64.56% vs. 66.16%), but AA patients had a longer time to first SCT (234 vs. 204.50 days, p=0.01). Among all patients, Charlson Comorbidity index (CCI) score of 0 (HR: 2.85, CI: 1.77-4.58) and CCI score of 1-2 (HR: 2.79, CI: 1.73-4.49) were significantly associated with an increased likelihood of receiving a SCT. MM diagnosis at an older age was associated with a lower likelihood of receiving a SCT (HR: 0.97, CI: 0.96-0.98). AA cohort exhibited a higher incidence of prior history of MGUS (10.63% vs 8.08%). Cytogenetic profile of the AA and other cohorts are shown in the Table below. Median OS was similar between the AA and other cohorts (145.61 vs. 146.50 months, respectively, p=0.88). Conclusions: AA patients had a longer duration of time to 1L therapy and 1st SCT in our RW study. Despite these differences in time to treatment, OS was similar across racial groups. Future studies are needed to explore the significance of our RW findings and other potentially important clinical characteristics.