Abstract: Multiple myeloma is hematological malignancy characterized by a clonal proliferation of malignant plasma cells in the bone marrow secreting a monoclonal immunoglobulin. Approximately 20% of patients with newly diagnosed myeloma present with renal failure and it is the second most common cause of death in these patients. This study was undertaken to review the spectrum of cases of myeloma from an exclusive renal centre. Renal disease was present in all patients before myeloma was diagnosed. All the 36 patients showed 'M'spike in serum electrophoresis and deranged renal function. Renal diseases consisted of mainly of acute renal failure (51%), chronic renal failure (36%) and nephrotic syndrome (13%). Thus, acute renal failure is the most common renal disease preceding the diagnosis of myeloma. Hence it is necessary to look for potential renal impairment in myeloma patients as reversal of renal function can be achieved with chemotherapy and hemodialysis treatment.