From the International Myeloma Workshop (IMW) 2019, held in Boston, MA, Maria-Victoria Mateos, MD, PhD, from University Hospital of Salamanca, Salamanca, Spain; Faith Davies, MBBCh, MRCP, MD, FRCPath from NYU Langone Medical Center, New York, NY, and Shaji Kumar, MD, from the Mayo Clinic, Rochester, Minnesota, discuss the current opinion on the best way to monitor and treat smoldering myeloma (SM), whether to use a curative or preventative approach.