Objective To analyze the characteristics of multiple myeloma(MM)patients at end-stage in order to introduce optimal therapeutic strategies for MM.Methods The clinical features of 84 end-stage multiple myeloma patients were analyzed and related literatures were reviewed.Results The pain in bone was the main complaint in 61.9%patients and bisphosphonates could treat bone disease effectively.Drug resistance including primary and secondary displayed in all patients.The primary drug resistance had a poor prognosis with median survival of only 11 months(range 7～14 months)and the secondary of 46 months(range 12-87 months)(P＜0.01).The main abnormal characteristics were infection.hematocytopenia,hypoproteinemia,renal inadequacy,electrolyte disturbances,cardiac inadequacy and abnormity of hemostasis and thrombosis.But hypoproteinemia was a rare event(4.8%).The patients who suffered from secondary plasmacytic leukemia,extramedullary tumor(intracal,canalis spinalis and serous cavity et al) and secondary tumor had a poor response to treatment and a shorter survival duration.Conclusion MM at end-stage has a poor prognosis and effective supportive therapies are very important for those patients.New strategies should be applied to those patients.