Abstract Introduction Recurrent Clostridioides difficile infection (rCDI) is common, with symptoms ranging from diarrhea to life-threatening sepsis. This study aimed to assess the real-world outcomes of patients with rCDI in the United States (US) who received fecal microbiota, live-jslm (RBL), the first US Food and Drug Administration-approved microbiota-based therapy for the prevention of rCDI after antibiotic treatment. Methods Adults with rCDI who received RBL between July 2023 and August 2024 at home or in a clinic and had ≥ 8 weeks of follow-up or experienced CDI recurrence at any time after RBL administration were included. Treatment success, defined as no CDI recurrence within 8 weeks of RBL, was assessed overall and in subgroups stratified by age, number of prior CDI recurrences, duration of the antibiotic washout period, prior bezlotoxumab use, and RBL administration setting. Results Among 196 patients who received RBL, 176 had either ≥ 8 weeks of follow-up or had