A 79-year-old female came to skin clinic with an ulcer, 15×20 cm, on her left shin. The laboratory report and both the skin and bone marrow biopsies reports, showed pyoderma gangrenosum associated with multiple myeloma. The patient was referred to hematology clinic for treatment. Multiple myeloma has rarely been associated with pyoderma gangrenosum. Multiple myeloma should be investigated in patients with paraproteinemia and pyoderma gangrenosum.