Abstract: Objective: To evaluate the role of Frailty score in prognosis the outcome of elderly multiple myeloma patients. Methods: Twenty nine multiple myeloma patients above 65 year-old diagnosed from January 1, 2015 to February 29, 2016, were enrolled in the retrospect study (one case was relapse patient, the other 24 cases were newly diagnosed patients). Frailty score assessment was performed and its relation with clinical outcome were analyzed. Results: The 29 patients were classified into high risk group(n=13, 45%), mediate group (n=5,17%), and low risk group (n=11, 38%). There were no differneces in the aspects of ISS stage(P=0.2807) or chemotherapy intensity(P=0. 0.4752) among the three groups. Thus, the two factors did not affect the analysis. More patients (69.2%) in the Frailty high risk group suffered severe hematologic adverse events (≥grade 3) as compared to low risk group (18.2%, P=0.0144), and to mediate risk group (0%, P=0.0106). As to the severe non-hematologic adverse events (≥grade 3), the occurrence in high risk group was 84.6%, higher than that of low risk group(18.2%, P=0.0014) and that of mediate risk group(20.0%, P=0.0114). Higher rate of chemotherapy discontinuation, delay or chemotherapy intensity reduction was observed in the high risk goup(76.9%), when the parameter of low, mediate risk group was 9.1% (P=0.0036), and 40.0%(P=0.2682). In the terms of therapy efficacy, 30.8%, 23.1%, and 46.1% patients obtained complete remission or very good remission(CR VGPR), partial remission (PR), and no remission (NR) in the high risk group, which was inferior related to that of low risk group(CR VGPR 63.6%, PR 36.4%, NR 0.0, P=0.027). The efficacy of high risk group was comparable with that of mediate risk group (CR VGPR 40.0%, PR 20.0%, NR 20.0%, P=0.7508).Conclusion: According to our preliminary data, the Frailty score is helpful in prognosis the treatment tolerance and effect of elderly multiple myeloma patients. The high risk group would have a poor outcome. However, the Frailty score system’s prognosis effect in elderly MM patients in China would be tested in further study.