Background: In the past years the bone seeking radiopharmaceutical samarium lexidronam (Sm-153-EDTMP) has been increasingly used alone or in conjunction with chemotherapy and/or bisphosphonates for the treatment of painful bone metastasis. Objective: Its use has been explored in different solid tumours. In this report we explore its interesting characteristics and describe our experience in multiple myeloma (MM). Methods: Sm-153-EDTMP has an affinity for bone and concentrates in areas of bone turnover. It decays as a therapeutic P-emission and at the same time as gamma-photon that can be used for tracking its concentration with bone scan imaging. Ten patients with symptomatic MM were treated to achieve pain control. Results: Encouraging results were obtained in MM patients. The use of this radioisotope could be largely improved.