GPRC5D (G Protein-Coupled Receptor Class C Group 5 Member D) is an orphan receptor highly expressed on malignant plasma cells in multiple myeloma, with restricted expression in normal tissues limited primarily to hair follicles and nail beds. Its specific expression on tumor cells, independent of BCMA, makes it a promising therapeutic target for T-cell redirecting therapies, particularly in relapsed/refractory multiple myeloma. Clinical studies with GPRC5D-targeting bispecific antibodies (e.g., talquetamab) and CAR-T cells have demonstrated significant efficacy. The main challenges include managing unique adverse events related to on-target, off-tumor effects in keratinized tissues (nail changes, skin rash, taste disturbances) and overcoming potential antigen escape-mediated resistance.