Purpose We assessed real-world spectrum and patterns of irAEs for patients treated with anti-PD(L)1 ICIs.Methods irAEs were defined using medical and pharmacy claims for patients enrolled in a Medicare Advantage Prescription Drug plan who initiated treatment with anti-PD(L)-1 and received ≥ 1 dose of therapy between 1 September 2014 and 28 February 2018.Results Treatment was discontinued for 46.6% of patients, and withheld and subsequently restarted for 10.3%. While toxicity profiles did not differ by age, RiskRx-V co-morbidity index was higher in patients with irAEs.Conclusion These data underscore the needs for tailored irAE diagnostic and management pathways.