Background: Multiple myeloma (MM) is a hematologic malignancy that accounts for 1% of all cancers and 10% of all hematologic malignancies. Autologous stem-cell transplantation (ASCT) has been the standard treatment of MM in transplantation-eligible patients since the 1990s and its use has increased in the United States over the last decade. Most clinical trials assessing the efficacy and safety of ASCT in MM enrolled patients younger age 65 years; however, the safety and feasibility of performing ASCT in patients with MM older than age 65 has been demonstrated retrospectively. Retrospective registry data have suggested that a higher hematopoietic stem cell transplantation comorbidity index score can predict worse outcomes in patients with MM undergoing ASCT. Most of the randomized studies have included patients younger than 65 years of age and so it becomes difficult to infer conclusions regarding this matter. Usually, age of participants is limited to 65 years to avoid selection bias and limit toxicities and withdrawal from studies. However, this does not mean that ASCT is not feasible in older patients. On the contrary, it is in select patients.