Anemia and bleeding are commonly observed in patients with multiple myeloma (MM). Anemia in MM is multifactorial in origin. Three common causes are marrow replacement by the malignant cells, thereby reducing the available number of BFU-E, chronic renal failure and shortening of the half life of erythrocytes. Some patients with anemia but without renal failure show a good response to erythropoietin (Epo) with full correction of anemia. This indicates that human Epo is a promising therapeutic tool or treating myeloma-associated anemia. The incidence of severe bleeding complications is low, despite the diversity of abnormal hemostatic tests in patients with MM. These patients frequently show abnormal coagulation tests, including thrombin time, fibrin degeneration products, platelet aggregation tests and bleeding time. The most effective therapeutic approach to bleeding is to treat the underlying malignancy. Supplemental to this, plasma exchange is useful.