CuidAME, the Spanish national registry for Spinal Muscular Atrophy (SMA), was created in 2020 to collect real-life data after the arrival of innovative therapies: Nusinersen (Ns, available in Spain since 2018), gene therapy Onasemnogene abeparvovec (GT, 2021) and Risdiplam (Rs, 2022). It includes all genetically confirmed SMA patients, despite their treatment, followed up in several Spanish hospitals (target population estimated at 1000 patients, followed at least for five years). The objective is to describe the characteristics of the SMA population in Spain. Observational registry that collects retrospective and prospective data: epidemiology, natural history, effect of treatments and impact of the disease. 543 patients (23 children, 270 adults) from 25 centers (2.4% deceased and 1.3% were lost of follow-up). SMA type distribution is: 23% SMA1, 35% SMA2, 38% SMA3, textless1% SMA4. Twelve patients (2%) were diagnosed presymptomatically (7 had 2SMN2 and 5 had 3SMN2). 495 patients (91%) received a disease-modifying therapy (DMT) during the follow-up: Ns 242 (45%), Rs 102 (19%) and GT 29 (5%). 17% received multiple treatments: 79 switches from Ns to Rs, and 13 AME1 children received both GT and Ns (except two). Six presymptomatic patients were treated with GT, four with Ns, two with Rs (median age at treatment: 46 days of life, current median age: 2.2 y.o). CuidAME is currently the platform containing Spanish largest, harmonized, and standardized SMA clinical lead database. The estimated population has already been recruited and is expected to increase due to the inclusion of new centers. It provides crucial data, allowing a better understanding of the disease, the efficacy and the adverse effects of innovative therapies. National and international collaborations among centers and registries are promoted, expanding SMA knowledge.