The main features of multiple myeloma bone disease (MBD) are hyperactivity of systemic bone destruction and inhibition of new bone formation. Its clinical manifestations include pain, osteoporosis, pathologic fractures and associated nerve compression symptoms etc. MBD is one of the most common complications of multiple myeloma (MM). Its misdiagnosis rate is higher, and the patients' quality of life and prognosis are poor. This review discusses the most recent advancement on its pathogenesis and novel therapies, so as to provide reference for clinical treatment of MBD.