Aims Anaplastic thyroid cancer (ATC) is a rare and aggressive malignancy with limited treatment options and a poor prognosis. This study evaluates the outcomes of patients with locally advanced or metastatic ATC treated at two tertiary centres, focusing on the efficacy of pembrolizumab and lenvatinib, and the impact of BRAF status. Method A retrospective review of 16 ATC patients treated between January 2018 and June 2024 at two tertiary Australian hospitals was conducted.