Ten patients with severe, treatment-resistant autoimmune conditions—five with antisynthetase syndrome and five with systemic sclerosis—experienced significant disease improvement when treated with bispecific T-cell engagers blinatumomab and teclistamab. Both conditions typically progress despite conventional immunosuppressive therapies, leaving patients with limited options and deteriorating organ function. This represents a notable departure from traditional autoimmune treatment paradigms, which focus on broad immunosuppression rather than precision targeting of specific immune cell interactions. Bispecific antibodies work by simultaneously binding to T-cells and disease-driving cells, creating artificial immune synapses that redirect T-cell cytotoxicity toward therapeutic targets. While these drugs have revolutionized certain blood cancers, their application to autoimmune diseases remains largely experimental. The approach carries theoretical risks of excessive immune activation or off-target effects, particularly concerning given autoimmune patients' already dysregulated immune systems. However, the tolerance profile in this small cohort appears encouraging. The case series format limits broader conclusions about efficacy and safety, but the results suggest these precision immunotherapies might offer hope for patients who have exhausted conventional options. Larger controlled trials will be essential to establish optimal dosing, duration, and patient selection criteria.