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Background and Importance Ferric carboxymaltose (FCM) is an injectable iron formulation indicated for the treatment of iron deficiency when oral preparations are ineffective, cannot be used, or when rapid administration is required.Aim and Objectives The aim of this study was to describe the use of FCM and to assess its indication according to the approved prescribing information.Material and Methods A cross-sectional observational study was conducted including all patients treated with FCM between 15 February and 7 March 2025. Demographic (age), clinical (prescribing department and comorbidities), analytical (haemoglobin [Hb], transferrin saturation index [TSAT], and ferritin), and treatment-related variables (previous, concomitant, and/or subsequent oral iron use; FCM dose) were collected.Results Seventy-six patients were included, with a mean age of 73 years (range 28–98). Of these, 20 (26%) were prescribed in the Surgery Department, 19 (25%) in Internal Medicine, 9 (12%) in Gastroenterology, and 7 (9%) in the Emergency Department. The most frequent comorbidities were oncological disease (29%), infection (28%), chronic heart failure (22%), chronic kidney disease (18%), and immune-mediated disease (4%). Seventy-four patients (97%) had Hb levels ≤14 g/dL, which dropped to ≤10 g/dL in 48 patients (63%). Among the 27 patients with an available iron profile, 24 had ferritin ≤30 µg/L and TSAT ≤23%. Twelve patients (16%) had previously received oral iron, 2 (3%) received it concomitantly, and 20 (26%) continued it afterwards. Of the 76 prescriptions, 50 (66%) were not justified: 35 cases (46%) lacked an iron profile request, 50 patients (66%) had not received prior oral iron therapy, and in 50 (66%) cases the administration was not considered urgent.Conclusion and Relevance A high proportion of patients received FCM in situations not aligned with its approved indications. These findings suggest the need to develop and implement a hospital-specific protocol for intravenous iron use, to ensure appropriate prescribing and to enable subsequent evaluation of outcomes following its implementation.Conflict of Interest No conflict of interest