Aim of work: In the current study, we aimed to investigate the added prognostic value of initial 18F-FDG PET/CT in patients with multiple myeloma on overall survival. Patients and Methods: This prospective study enrolled 50 adult patients with pathologically proven multiple myeloma, referred for initial pre-therapy and posttherapy FDG-PET-CT studies. Initial laboratory investigations were also done. Semi-quantitative analysis was done. Follow up period was 6 – 24 months. Results: among the 50 patients; Patients with plasma cell count more than >10 %) (P value 0.026) and albumin to globulin ratio ≤0.5 showed significantly lower overall survival compared to other patients. Regarding initial PET-CT derived volumetric parameters; there was no statistical significance regarding prediction of overall survival. Conclusion: Biological data (A/G ratio) could have a valuable predictive value for overall survival.