Background This study aimed to evaluate the efficacy and safety of telitacicept for the treatment of lupus nephritis (LN) in real-world clinical practice.Methods Adult patients with LN receiving additional telitacicept at 80/160 mg once per week were recruited, while patients receiving only standard therapy were included as the control group using a 1:1 propensity score-matching approach. The primary outcomes were the proportions of patients achieving complete renal response (CRR) and primary efficacy renal response (PERR).Results Forty-four patients in both the control and telitacicept groups were enrolled, with median follow-up periods of 10.78 +/- 3.37 and 10.5 +/- 3.78 months, respectively. Compared with the control group, a significant improvement was observed in the proportion of patients achieving CRR (11.36% vs 29.55%, P = .034) and PERR (45.45% vs 68.18%, P = .031) in the telitacicept group at the last visit. Median proteinuria was reduced by 0.97 g/day (63.82%) from baseline in the telitacicept group, compared with a reduction of 0.31 g/day (25.31%) in the control group. Additionally, the telitacicept group showed notable treatment responses in the median SLE Disease Activity Index-2000 score, Physician's Global Assessment score and glucocorticoid dose reduction. Subgroup analysis revealed that telitacicept exhibited a more prominent therapeutic effect in patients with type V LN and those with proteinuria exceeding 3 g/day. Telitacicept was well tolerated, and the incidence of adverse events was similar between the two groups.Conclusions LN patients receiving additional telitacicept treatment demonstrated better disease remission, particularly in those with type V LN and proteinuria >= 3 g/day, with a favorable safety profile in real-world clinical practice.