Carfilzomib, lenalidomide and dexamethasone (KRd) is still a widely used treatment option for patients with relapsed / refractory multiple myeloma (RRMM). However, there is limited real-world evidence. Here we evaluated the efficacy and safety of KRd in patients with RRMM treated following the standard clinical practice of the hospitals in the Catalan region. This was a retrospective, observational study. The objective response rate (ORR) according to IMWG criteria was the primary endpoint. Secondary endpoints included progression-free survival (PFS) and overall survival (OS). The study planned to include at least 100-150 patients. In total 194 patients were included. Median age was 64 years (range: 40-88) and 56% were male. All patients had received bortezomib. Additionally, 89 patients (46%) had received thalidomide and 29 (15%) lenalidomide. The ORR was 73% (95% CI: 66-79), with 72 patients (37%) having ≥ CR. The ORR was influenced by ISS score, number of previous treatments and exposure to lenalidomide. The median PFS was 26 months and 2-years OS rate 70%. The ISS stage and LDH levels were independent prognostic factors of survival. In conclusion, the KRd scheme led to a good effectiveness comparable safety profile to the phase III clinical trial in patients with RRMM.