Introduction Bone marrow angiogenesis is increased in multiple myeloma (MM) and is an important prognostic factor for survival. Newly diagnosed MM patients have higher microvessel density (MVD) than controls on bone marrow biopsies. In addition, patients with higher MVD, receiving conventional chemotherapy or high-dose therapy with autologous stem cell transplantation, have shorter median overall survival than those with lower MVD by using the median MVD as the cutoff. In a study with 81 patients with MM treated with thalidomide with or without dexamethasone, MVD decreased significantly in responders while no significant change in MVD was seen in those failing to respond to thalidomide.