Thalidomide (Thal) has been used for a few years as salvage treatment for patients with multiple myeloma (MM). However, the response rate in Chinese patients treated with Thal has not been determined and the prognostic factors for response rate (RR), progression-free survival (PFS) and overall survival (OS) not yet well identified. This study enrolled 110 Chinese patients with MM who received either Thal alone, Thal plus dexamethasone (Thal + Dex) or Thal plus conventional chemotherapy (Thal + CC). Their laboratory and clinical parameters were retrospectively analysed. The overall RR was 63.6% (complete response rate 6.4%, partial response rate 57.3%). Patients aged < 65 years, time from diagnosis to the start of Thal treatment < 6 months or combined therapy had a significantly higher RR (p < 0.05). In univariate analysis, age < 65years predicted a longer PFS (p = 0.008). Age < 65 years, serum creatinine < 176.8 micromol L-1 and serum beta 2 microglobulin (beta2M) < 3.5 mg L-1 were associated with longer OS (p = 0.028, 0.045 and 0.019, respectively). Multi-factor analysis suggested that serum beta2M was the only independent prognostic factor for OS (p = 0.025).