Since 1983 an increasing number of clinical trials have used high-dose melphalan with or without autologous stem cell support in patients with multiple myeloma. It has been shown that high-dose therapy including high-dose melphalan may be considered as the treatment of choice in newly diagnosed patients. The purpose of this report is to review and summarize the clinical information on IV high-dose melphalan in patients with multiple myeloma and to examine potential areas of future investigation.