Substantial progress has been made in understanding the role of autotransplants in multiple myeloma. High dose therapy consistently induces a higher remission rate, longer remission duration, and overall survival. This article summarizes the results of several major studies to illustrate the above conclusions. Feasibility of autotransplants in patients with renal failure, utility of stem cell selection, and prognostic factors are also discussed. Autotransplants should be part of the overall treatment strategy for newly diagnosed myeloma patients under 70 years of age.