43 years male a case of IgG Kappa Multiple myeloma R-ISS III. Bone marrow aspirate revealed 92% clonal plasma cells with atypical morphology (Fig A). Karyotyping showed a complex hyperdiploid karyotype and 1q gain with 1p deletion (Fig B). Myeloma FISH panel also showed high risk features of 1q amplification and 1p loss in 92% cells (Fig C). Our case highlights the correlation between atypical plasma cells morphology and complex karyotype pattern in a young patient of multiple myeloma.