BACKGROUND: The treatment landscape for multiple myeloma (MM) has significantly progressed in recent decades. METHODS: We analyzed the treatment patterns and clinical outcomes in Korean patients using data from the National Health Insurance Service database. Patients diagnosed with MM between 2010 and 2018 were included. Survival analysis with a Cox regression model was performed. RESULTS: A total of 8,367 patients with MM were identified, from which 2,442 patients underwent stem cell transplantation (SCT). The mean patients' age at diagnosis was 67.1 years. Since 2011, the combination of a proteasome inhibitor (PI) and an alkylating agent has been most common, with a significant increase in the PI and immunomodulatory drug (IMiD) combination after 2015. The attrition rates after first-line therapy were 45% and 56% for the SCT and non-SCT groups, respectively. Patients on bortezomib, melphalan, and prednisolone were younger with less renal insufficiency compared to those on lenalidomide and dexamethasone. The SCT group had a median overall survival (OS) of 7.04 years, significantly higher than the non-SCT group's 2.52 years. CONCLUSIONS: SCT eligibility and the reimbursement status of new drugs impact the treatment pattern of MM. Expanding access to new agents and identifying patients who can benefit from SCT are essential.