The study analyzed the prognostic factors of overall survival in 87 patients with immunoglobulin light chain (AL) amyloidosis in a hospital in Ningxia Hui Autonomous Region. Median overall survival was 22.0 months (95% CI: 15.2–28.8) and median follow-up was 39.0 months (95% CI: 29.2–48.8). Higher bone marrow plasma cell counts (BMPC > 12%), presence of myeloma, heart failure, and elevated fibrinogen degradation products (FDP) were associated with poor survival. Patients with BMPC >12% had a median survival of 13 months versus 36 months for patients with lower values. In the presence of myeloma, the median survival was 15 months compared to 36 months without myeloma. Multivariable analysis confirmed myeloma (HR = 2.582, 95% CI: 1.105–6.034, p = 0.029), heart failure (HR = 2.258, 95% CI: 1.098–4.641, p = 0.027), older age (HR = 1.018, 95% CI: 1.001–1.035, p = 0.035) and increased FDP (HR = 1.018, 95% CI: 1.004–1.017, p = 0.001) as independent risk factors for death. These factors can help in risk stratification and treatment planning.