Treatment of multiple myeloma (MM) has evolved greatly over the past decade, and owing to immunomodulatory agents (thalidomide and lenalidomide) and proteasome inhibition (bortezomib), patients with MM enjoy prolonged survival and improved quality of life. Use of these novel agents has improved the rate of complete remissions in MM, a parameter that has emerged as an important step towards improved survival. Bortezomib should now be considered as an established component of the induction treatment prior to autologous transplantation in younger patients. The combination of melphalan/prednisone with a novel agent is a new standard of care for elderly patients with MM. The beneficial effect of these treatment approaches is also seen in special MM populations, in particular in those with impaired renal function and high-risk cytogenetic features.