A multigap resistive plate chamber (MRPC) is a gaseous detector capable of achieving tens-of-picoseconds timing precision. In this study, we investigated the feasibility of integrating an MRPC detector as part of a time-of-flight (TOF) system for carbon-ion radiotherapy. The detector was constructed using low-resistivity glass ( \(\sim 10^9\,\Omega \cdot \textrm{cm}\) ) and tested with both a standard gas mixture (98% C \(_2\) F \(_4\) H \(_2\) + 2% SF \(_6\) ) and a pure eco-friendly HFO-1234ze gas configuration (100% C \(_3\) F \(_4\) H \(_2\) ). Under a 10-GeV/ \(c\) pion beam at CERN’s T10 facility, the MRPC achieved a time resolution of approximately 70 ps and an efficiency exceeding 96% at an operating voltage of 12.5 kV using the standard gas mixture. Additional measurements showed that, although the detector performance degraded at higher beam rates (up to 200 kHz), the time resolution remained within approximately 130 ps for the standard gas mixture and approximately 160 ps for the eco-friendly gas mixture, with efficiencies remaining above approximately 86% and 75%, respectively. Energy resolution calculations for carbon-ion beams (0–500 MeV/u), based on these timing measurements, suggest that clinically meaningful accuracy may be achievable; however, the present experimental data indicate that further refinement is still required to satisfy stringent clinical tolerances. Despite this performance gap, the results highlight the MRPC’s promise in real-time energy monitoring for heavy-ion therapy, with the advantage of minimal interference with the treatment beam. Future work will focus on improving the system’s readout electronics and high-rate response to achieve clinically acceptable energy resolutions in carbon-ion beam therapy. This research lays the experimental foundation for the development of a dual-MRPC TOF system for precise energy measurement in particle radiotherapy.