European case-control study evaluates occupational risk of multiple myeloma (MM) in 277MM cases and 1108 matched controls, using logistic regression analysis and adjusting by age, gender, study centre and education. An increase in MM risk was observed for general farmers, cleaners, telephone and radio operators, and printers. Pesticide exposure lasting ten years or more, but not exposure to solvents, was also associated with an elevated MM risk (OR = 1.62; 95% CI 1.01-2.58). Our results confirm an association of multiple myeloma with farm work, and particularly with prolonged exposure to pesticides.