OBJECTIVE To analyze the clinical features of patients with newly diagnosed myeloma bone disease (MBD). METHODS Clinical features of MBD in two hundred and five patients with newly diagnosed multiple myeloma (MM) were analyzed retrospectively. The relationship between outcome of different grades of MBD patients and their prognosis was compared. RESULTS (1) Among the 205 patients, one hundred and fifty (72.7%) had bone pain as the first symptom. (2) According to X-ray evaluation, there were 23 (11.3%) of grade 0, 14 (6.9%) grade 1, 23 (11.3%) of grade 2, 68 (33.3%) grade 3 and 76 (37.2%) grade 4. (3) Patients with grade2-4 MBD had significantly higher ECOG performance score, marrow plasmacytes, marrow CD138(+) CD38(+) cell percentage and serum IL-6 level than those with grade 0 - 1 did (P < 0.05). Patients with grade 4 MBD presented with hypocalcemia (P < 0.05) more often than those with grades 0 - 3 diseases did. (4) There was no significant difference in response to initial induction chemotherapy among the five groups (P = 0.642). (5) Univariate analysis demonstrated that the time to progression (TTP) in grade 2 - 4 MBD groups was significantly shorter than that in grade 0 - 1 groups (P = 0.029). (6) Multivariable COX analysis did not indicate lytic bone changes was a independent prognostic factor for OS and TTP. CONCLUSIONS There is a rather high incidence of MBD in MM patients in China. Patients with extensive X-ray bone lesions have more severe hematologic parameters than those without bone lesions did, and severe bone lesions is an important adverse prognostic factor for TTP.