The disease burden of multiple myeloma (MM) has been continuously increasing globally and in China. In 2021, the number of newly-diagnosed MM cases globally reached 148 754.63, and the number of deaths was 116 359.63. In China, the number of newly-diagnosed cases was 17 250, and the number of deaths was 12 984. The burden is heavier in males, elderly populations, and economically developed regions, while the rising prevalence in younger populations also deserves attention. The disease burden of MM is expected to continue to increase in the future, with high body mass index being an important associated risk factor. In 2025, the "Clinical Practice Guidelines in Oncology: Multiple Myeloma" issued by the National Comprehensive Cancer Network (NCCN) underwent rapid iterations from Version 1.2026 (hereafter referred to as 2026.V1) to Version 3.2026 (2026.V3), covering the entire process of MM diagnosis and treatment. This study compares and interprets the 2026.V1 guideline with the 2025.V2 version, and supplements the interpretation of updates in 2026.V2 and 2026.V3, aiming to help clinicians improve MM diagnosis and treatment, optimize the management of high-risk MM patients, and further enhance the prognosis of MM patients in China. The core content of this study can be summarized as "three additions, four optimizations, two focuses, and one emphasis". The "three additions" include the incorporation of individualized treatment for special populations, diagnostic and therapeutic pathways for MM with central nervous system (CNS) involvement, and management of monoclonal immunoglobulin deposition disease (MIDD). The "four optimizations" include strengthening the application of next-generation sequencing (NGS) and renal biopsy in diagnostic examination, incorporating International Myeloma Society/International Myeloma Working Group (IMS-IMWG) criteria in high-risk stratification for precise identification of high-risk patients, emphasizing four-drug combination priority for newly diagnosed patients and earlier use of immunotherapy for relapsed patients in treatment regimens, and clarifying the timing of PET/CT application in follow-up monitoring. The "two focuses" refer to focusing on infection prevention (refining infection control for treatments such as chimeric antigen receptor T cell therapy [CAR-T]) and renal function protection (clarif-ying preferred drugs and doses of bone-modifying agents). The "one emphasis" refers to giving attention to the management of solitary plasmacytoma and smoldering myeloma subtypes. The 2026.V1 guideline focuses on "precision, diversity, and whole-course management", highlighting multidisciplinary collaboration and individualized treatment, while the 2026.V2 and 2026.V3 further optimize drug recommendations for relapsed/refractory patients.