Objective  To investigate the clinical efficacy and safety of telitacicept in the treatment of IgA nephropathy.  Methods  The clinical data of patients with IgA nephropathy treated with telitacicept from March 2022 to March 2024 were retrospectively collected. Their laboratory indicators and adverse reactions were recorded to evaluate the efficacy and safety of telitacicept.  Result  A total of 106 patients were analyzed, with a median medication time of 3.2 (2.2～5.7) months and median follow-up time of 5.4 (3.2～11.5) months. The 24-hour proteinuria decreased by 38.6% (-58.9%～1.8%) (Z=-2.929, P=0.003) from baseline at the sixth month after medication. The levels of IgA, IgG and IgM decreased from baseline; IgA decreased by 30.9% (t=8.857, P＜0.001), IgG 18.1% (t=5.305, P＜0.001) and IgM 43.6% (t=6.732, P＜0.001). Before medication, proteinuria ＜3.5 g/d (OR=6.483, 95% CI:1.259～33.389, P=0.025) and eGFR＞60ml/(min·1.73m2) (OR=4.552, 95% CI:1.043～19.860, P=0.044) were associated with proteinuria dropping to 1.0g/d after medication. Adverse reactions were infections and injection site reactions.  Conclusion  Telitacicept can significantly reduce proteinuria in patients with IgA nephropathy, and early application may be more effective.