Introduction: Hyperviscosity syndrome is regarded as a rare oncological emergency with a bleak prognosis. Though it is more commonly found in patients of Waldenstrom__ampersandsignrsquo;s macroglobulinemia and only 2-6% cases are reported in multiple myeloma. Aim: To highlight the therapeutic burden vindicated by Hyperviscosity syndrome over a case of multiple myeloma. Case Report: A 46-Year-old male patient presented to the emergency department with a history of two episodes of epistaxis with a mild headache for a few hours. The patient gave a history of bony pain at night. On investigation, the patient__ampersandsignrsquo;s complete blood count revealed Hb-1.2g/dl, TLC-6300 cells, platelet count -77 lakhs/cu mm) and Peripheral smear-showed RBC in rouleaux formation. Bone marrow showed myeloma cells. X-ray skull [lateral view] showed punched-out lytic lesions. Urine examination showed no Benz Jones proteins. Hyperviscosity syndrome ultimately leads to the patient__ampersandsignrsquo;s demise. Methods: We are reporting a case of multiple myeloma in a 46-year-old male who presented with epistaxis and acute kidney injury as part of Hyperviscosity syndrome. The database was searched from google, PubMed, Scopus and web of science. Conclusion: This case report represents the minority of multiple myeloma patients. This case report represents the minority of multiple myeloma patients. Hyperviscosity syndrome presents as a significant touchstone when dealing with patients with multiple myeloma and the complications following HVS can be often fatal while the patient may present with varied clinical features each separate time.