Monoclonal gammopathy of undetermined significance (MGUS) is a clinically mute, asymptomatic condition defined by the presence of a serum monoclonal protein (M-Ig) level of less than 30 g/l and a bone marrow plasmocyte infiltration of less than 10%. This condition represents the most common type of gammopathy and accounts for 50% of all gammopathies. MGUS has a long-term risk of progression to active disease such as symptomatic multiple myeloma or other malignancy. Predictors of risk of malignant transformation are abnormalities of cytogenetics, peripheral blood free light chain ratios, and plasmocyte immunophenotype. These factors help to identify a high-risk group of patients with MGUS. Monitoring is essential because of possible progression to asymptomatic myeloma or other forms of the disease[1].