Summary Real‐world data describing management of patients with multiple myeloma are limited. A European (Belgium, France, Germany, Italy, Spain, Switzerland, UK) observational chart review was conducted to address this. Physicians completed questionnaires for every patient seen during a 2–4‐week observation period, regardless of treatment status. A total of 435 physicians completed 7635 cross‐sectional chart reviews. Overall, 47% of patients were undergoing anti‐tumour drug treatment, 42% had previously received ≥1 line of treatment and 12% had never received anti‐tumour drug treatment. Of the patients treated by oncologists, onco‐haematologists or internists, 95% received, or were expected to receive, at least one line of anti‐tumour drug treatment, 61% received ≥2 lines of therapy and 38% received ≥3 lines. Except in the UK, the most commonly used induction therapies contained bortezomib (48%); lenalidomide was the most commonly used first‐line maintenance therapy (45%) and second‐ and third‐line agent overall (60% and 52% of patients at those lines, respectively). Bortezomib retreatment was used in 47% of patients who received it first line. Treatment patterns became more diverse with subsequent treatment lines. This study provides insight into real‐world treatment patterns in Europe. While treatment practices are broadly similar across countries, some notable differences in the agents used exist.