Objective: To evaluate the efficacy and safety of thalidomide (Thai) plus dexamethasone (Dex) as the initial therapy in elderly patients with newly diagnosed multiple myeloma (MM). Patient and methods: prospective longitudinal follow-up intervention of 26 elderly patients who underwent the TD regimen (Thai 100 mg/day, Dex 40 mg/day) as the initial therapy. Results: A total of 26 patients were followed up with a median of 18,7 + or - 11,2 months (3-48). During the follow up, only 6 patients died (40 percent) and, therefore, median OS values were not available. It is estimated, however, that the mean survival time was 18,2 months. All of the patients tolerated the treatment well. The inddence of AES in patients with a grading above 3 was 15,3 percent. Conclusions: The TD regimen results in a high response rate and manageable AES as the initial therapy in elderly patients with newly diagnosed MM.