Purpose of Review <p>This review aims to explore key clinical considerations for prescribing exercise in individuals with multiple myeloma (MM) and to evaluate current evidence to develop exercise regimens that prioritize both safety and efficacy.</p> Recent Findings <p>MM is a hematological cancer characterized by complex complications, including unstable bone lesions, cardiac amyloidosis, peripheral neuropathy, and cytopenia, which collectively impair patients' health and quality of life. Exercise training has emerged as a critical component of supportive care in MM; however, the complexity of the disease and its associated comorbidities pose challenges to designing safe and effective interventions. Recent evidence underscores the potential benefits of aerobic and resistance training, yet there is no consensus on optimal exercise protocols. Tools such as cardiopulmonary exercise testing, fracture risk assessment, and blood biomarker monitoring have shown promise in personalizing exercise prescriptions.</p> Summary <p>Although the feasibility and short-term benefits of exercise interventions for MM are well-established, significant gaps in knowledge persist regarding their long-term effects on disease progression, survival, and quality of life. Future research is needed to address these gaps and refine evidence-based exercise guidelines for this unique patient population.</p> Graphical Abstract <p></p>