There is significant variation in the survival of patients with myeloma. This article reviews the major prognostic factors in myeloma and the evidence supporting their usefulness in clinical practice and research. The factors reviewed include serum beta 2-microglobulin, bone marrow plasma cell labeling index, cytogenetics, plasmablastic morphology, and other standard clinical laboratory variables. Novel factors such as bone marrow angiogenesis are also discussed. A combination of independent factors provides greater prognostic information than any one factor alone, and survival data using various combinations of prognostic factors are presented.