Due to the diversity of clinical manifestations of multiple myeloma (MM), different first symptoms, and multiple first departments, the misdiagnosis rate is very high in clinical practice, reported to be over 60%. Clinicians, especially non-hematologists, are not sufficiently aware and vigilant about this disease, and tend to limit the diagnosis to one systemic disease without systematic examination; they pay little attention to abnormalities such as abnormal globulin nodules or anemia found in laboratory tests, and lack comprehensive and correct analysis of clinical manifestations and laboratory tests, which are important reasons for MM to be misdiagnosed. In addition, some patients are reluctant to undergo bone marrow examination, which can also delay the timely diagnosis of the disease. In clinical practice, attention should be paid to the following aspects to reduce the misdiagnosis rate: (1) unexplained bone pain or pathological fractures; those with bone induration on examination and masses in flat bones; early paraplegic symptoms (such as weakness of lower limbs and difficulty in urination); (2) middle-aged and elderly patients with unexplained proteinuria, azotemia, anemia not parallel to the degree of renal failure, not high blood pressure, normal kidney size, accompanied by bone pain; (3) recurrent pulmonary infections or urinary tract infections that are ineffective with anti-infective treatment, especially in combination with anemia, bone pain, and increased blood sedimentation that persists without decreasing; (4) unexplained anemia with bone pain; (5) laboratory tests that reveal significant hyperglobulinemia or significantly decreased globulin. In addition, further improving access to medical care for low-income people and raising awareness of the disease among primary care physicians can also reduce the incidence of misdiagnosis to some extent. For patients with high suspicion of MM, immunoglobulins, urine Benzedrine, X-ray radiographs and bone marrow examination should be promptly checked. Multi-site X-ray examination is important for the diagnosis of this disease, and multiple round areas of bone destruction of varying sizes (especially in the skull, ribs, vertebrae, and pelvis) can be detected, and ECT, CT, and MRI can be performed when necessary. sometimes, extensive osteoporosis can be the only X-ray manifestation of myeloma. Since MM is focally distributed, a negative bone marrow examination does not exclude MM, and multi-site aspiration or bone marrow biopsy is required for early and definitive diagnosis.