<p>Until the early 2020s, standard mantle cell lymphoma (MCL) treatment in Germany primarily included chemoimmunotherapy, autologous stem cell transplantation (autoSCT) for eligible patients in first line, and covalent Bruton tyrosine kinase inhibitors (cBTKis; ibrutinib at the time) for relapsed/refractory disease. However, real-world data on MCL treatment patterns and outcomes in Germany remain scarce. This retrospective observational study analyzed administrative claims data between 2015 and 2020. Annual incidence and prevalence, treatment patterns, healthcare visits, and overall survival (OS) were evaluated. Extrapolated to the German statutory health insurance population, annual MCL prevalence and incidence rates (per 100,000 individuals) ranged from 6.64 to 10.02 and from 1.28 to 2.06, respectively, showing an upward trend. Among 369 patients with MCL in the database (2015–2020) receiving at least one anti-cancer treatment, median age at diagnosis was 71 years and average Charlson Comorbidity Index was 2.9. In first-line, patients mainly received chemoimmunotherapy (77.2%; <i>n</i> = 285); 13.8% (<i>n</i> = 51) underwent autoSCT, and 30.9% (<i>n</i> = 114) received rituximab maintenance; in second-line (<i>n</i> = 193), 45.6% received chemoimmunotherapy and 22.3% a cBTKi. Median OS from diagnosis was 6.3 years. In cBTKi-treated patients (<i>n</i> = 82), median OS from first cBTKi therapy initiation (&gt; 75% of the patients received cBTKi in second or third line) was 11.2 months, decreasing to 3.0 months from cBTKi discontinuation (<i>n</i> = 45). This study presents the first comprehensive analysis of MCL epidemiology, treatment patterns, and survival outcomes in Germany using claims data. Findings indicate rising MCL incidence and prevalence, a high treatment burden and poor survival outcomes, underscoring the need for treatment advancements.</p>