Myelofibrosis (MF) is a hematological malignancy characterized by disrupted blood cell production and bone marrow scarring. Ruxolitinib (Jakafi, approved in November 2011) and fedratinib (Inrebic, approved in August 2019) are the only two FDA-approved drugs for MF in the United States. Although Jakafi offers a therapeutic option, it is associated with high discontinuation rates and loss of response, and it does not address all MF symptoms. Therefore, significant market opportunity remains for safe and tolerable treatments that can manage the full spectrum of symptoms, as well as for treatment options for patients with baseline thrombocytopenia and anemia. This report explores the current prescribing practices for MF, the various factors driving treatment decisions, and the changes in prescribing that are expected to occur in the coming year.