Multiple myeloma (MM) is a clonal plasma cell abnormal proliferative disease, accounting for about 1% of malignant tumors and about 15% of hematopoietic malignancies, mostly seen in elderly people aged 50-60 years or older, but due to its complex and varied clinical manifestations and non-specific nature, it is very easy to be misdiagnosed, with some reports showing a misdiagnosis rate of 84-85%, thus delaying treatment. Because tumor cells secrete cytokines to activate osteoclasts, causing osteoporosis and osteolytic lesions, multiple myeloma is most likely to be misdiagnosed as an orthopedic disease. Due to the deposition of protein in the cytoplasm of epithelial cells after being absorbed by the proximal tubule, causing degeneration and necrosis, coupled with hypercalcemia, hyperviscosity, amyloidosis and infiltration of myeloma cells into the kidney, chronic renal impairment is also a major complication and early manifestation of multiple myeloma. Patients often have varying degrees of proteinuria, and about half of them may develop renal insufficiency and be misdiagnosed as kidney disease. Although multiple myeloma is a common and frequent disease in hematology, its overall incidence is about 1/100,000 in China, and it is still a relatively rare disease for non-hematologists, and clinicians do not know enough about it, so it is easily misdiagnosed. The following conditions should be taken seriously in elderly people: unexplained bone pain or pathological fracture; early symptoms of paraplegia such as weakness of lower limbs and difficulty in urination; unexplained renal impairment proteinuria, azotemia, anemia disproportionate to the degree of renal failure, blood pressure not high, normal kidney size; unexplained anemia with bone pain; recurrent pulmonary infection or urinary tract infection, ineffective by anti-infection treatment, especially The combination of anemia, bone pain, and increased blood sedimentation that does not decrease continuously. In conclusion, multiple myeloma is prone to misdiagnosis due to its insidious onset and diverse clinical manifestations in the early stage of the disease.