Multiple myeloma (MM) is an incurable malignancy of the plasma cells. Most patients are diagnosed when they are older than 65 years. Therapeutic options include chemotherapy, using either established (e.g. melphalan) or newly available (e.g. thalidomide) drugs and high-dose treatment with stem-cell support (autologous as well as allogeneic). Recent research has focused on defining the target population for the different therapeutic approaches, taking into account pre-treatment characteristics of patients, particularly age, and aims to balance treatment benefit with potential adverse events. In this review we present the data available on the most recent trials dealing with the treatment of elderly MM patients.