Amer Zeidan, MBBS; Catherine Lai, MD; Bart Scott, MD; Andrew Brunner, MD; Jonathan Abbas, MD; Akriti Jain, MD; Mohamed Hegazi, MD; Somedeb Ball, MBBS; and Salman Fazal, MD, examine critical clinical decisions in myelodysplastic syndrome management, including optimal sequencing of erythropoiesis-stimulating agents vs luspatercept, dosing strategies, and efficacy data from pivotal trials such as MEDALIST, IMerge, and ELEMENT-MDS, which demonstrate improvements in transfusion burden and hemoglobin levels.