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Background Idecabtagene vicleucel (ide-cel) is a B-cell maturation antigen (BCMA)-directed chimeric antigen receptor (CAR) T-cell therapy, it has emerged as a transformative treatment for relapsed/refractory multiple myeloma (R/RMM). On April 4, 2024, the U.S. Food and Drug Administration (FDA) approved ide-cel for adult patients with R/RMM who have received at least two prior lines of therapy, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 monoclonal antibody. This meta-analysis evaluates the efficacy and safety outcomes of ide-cel from current clinical evidence. Methods A systematic search of Medline, Embase, Cochrane Library, Web of Science, and Scopus was conducted through July 2025 and supplemented with data from ClinicalTrials.gov. Five relevant clinical trials (n=730 patients) were included. We analyzed outcomes such as overall response rate (ORR), complete response (CR) rate, progression-free survival (PFS), and safety endpoints such as cytokine release syndrome (CRS), neurotoxicity, infections, and treatment-related mortality (TRM). Pooled estimates were calculated using weighted averages based on sample size. Results The pooled ORR was 72.9%, with a CR or better rate of 30.2%. Median PFS across studies was 9.7 months. CRS occurred in 81.8% of patients, with grade ≥3 CRS in 3.7%. Neurotoxicity was reported in 27.1% of patients, including 4.6% with grade ≥3 events. Infections were noted in 44.8% of patients, and TRM was 5.5%, primarily due to infections or immune-mediated toxicity. CRS and neurotoxicity were largely early-onset and manageable with tocilizumab and corticosteroids. Toxicity incidence increased with higher CAR T-cell doses and advanced disease burden. Conclusion Ide-cel demonstrates strong efficacy in heavily pretreated R/RMM patients, with high response rates and a median PFS approaching 10 months. The safety profile is characterized by frequent but manageable CRS and neurotoxicity, and infections remain a key consideration. These findings support ide-cel as a valuable treatment option in R/RMM, in line with its recent FDA approval. It is suggested to maintain ongoing monitoring and long-term follow-up to fully assess durability of benefit and late-onset toxicities or even second primary malignancies.