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Summary: Background: Psoriasis is a chronic inflammatory skin disease requiring prolonged treatment. New biologic therapies require long‐term evaluation to assess the durability of their efficacy and safety profiles over time. Objectives: To evaluate the long‐term efficacy and safety of risankizumab (RZB) for the treatment of psoriasis. Methods: LIMMitless is an ongoing, phase III, open‐label extension study evaluating the long‐term efficacy and safety of RZB in adults with moderate‐to‐severe plaque psoriasis following multiple phase II/III studies. This analysis assessed efficacy through 172 weeks of continuous RZB treatment by examining the proportion of patients achieving ≥ 90% or 100% improvement in Psoriasis Area and Severity Index (PASI 90 and PASI 100), static Physician's Global Assessment of clear or almost clear (sPGA 0/1) and Dermatology Life Quality Index of no effect on quality of life (DLQI 0/1). Safety was assessed by recording adverse events (AEs) through the data cutoff date. The study is registered at ClinicalTrials.gov (identifier: NCT03047395). Results: Of 955 patients randomized to RZB 150 mg in the base studies, 897 patients continued into LIMMitless; 799 patients were still receiving treatment in LIMMitless at the time of data cutoff for this analysis. After 172 weeks of continuous RZB treatment, 85·5% of patients achieved PASI 90, 54·4% achieved PASI 100, 85·2% achieved sPGA 0/1, and 78·4% achieved DLQI 0/1 using modified nonresponder imputation. Rates of AEs leading to discontinuation and AEs of safety interest were low with long‐term treatment and comparable with those identified in the base studies. Conclusions: Overall, long‐term continuous RZB was well tolerated and showed high and durable efficacy over 172 weeks. What is already known about this topic? Risankizumab is a humanized immunoglobulin G1 monoclonal antibody that specifically inhibits interleukin‐23 by binding to its p19 subunit.In multiple phase II/III clinical trials in adults with moderate‐to‐severe psoriasis, risankizumab has displayed superior efficacy vs. placebo or other psoriasis treatments for up to 52 weeks. What does this study add? LIMMitless is an ongoing phase III open‐label extension study designed to evaluate the long‐term safety and efficacy of risankizumab treatment for up to 5 years of continuous use.The results from this interim analysis demonstrate that risankizumab offers sustained efficacy after more than 3 years of continuous use, with no new safety signals identified. Linked Comment: S. Gerdes and J. Albrecht. Br J Dermatol 2021; 185: 1086–1087. [ABSTRACT FROM AUTHOR]