María-Victoria Mateos, MD, PhD, from the University Hospital of Salamanca, Salamanca, Spain gives an overview of the challenges associated with assessing and treating smouldering myeloma. Smouldering myeloma is a heterogeneous disease and Dr Mateos explains how the difficulty in assessing whether a patient is at risk of progressing to symptomatic myeloma, can vary from case to case. She explains the use of the Mayo Clinic model and monitoring strategies in case of low, intermediate and high risk of progression to myeloma. For high risk patients, Dr Mateos suggests that in future, they will be offered an early treatment. Recorded at the 2016 World Congress on Controversies in Multiple Myeloma (COMy) in Paris, France.