The growing demand for management models that promote alignment, focus, and performance measurement has driven the use of the OKR methodology (Objectives and Key Results) in environments that employ agile methodologies in software development. However, the integration between these approaches presents practical challenges related to distinct work cycles, the definition of measurable goals, and the cultural impact of implementation. This work aims to analyze the main challenges faced in the adoption of OKRs in agile teams, based on a review of specialized literature and a case study in a systemic integration project between two large Brazilian companies in the healthcare sector. The methodology combined bibliographic research and applied qualitative approach, with structured analysis in four stages: process mapping, GAP classification, quarterly planning based on OKRs, and continuous monitoring of deliveries. The results show that, despite initial obstacles, adopting OKRs contributes to better alignment between technology and business, improving project governance and strengthening a culture of shared responsibility, as long as it is adapted to the characteristics of agile environments.