Multiple myeloma is a neoplastic plasma cell dyscrasia. Patients usually present with bone pain, anemia, hypercalcemia and renal failure. Unusual presentations include progressive bilateral carpal tunnel syndrome, polyarthritis, amyloidosis of the tongue, and involvement of pulmonary parenchyma. Early diagnosis is important for timely therapy. We present the case of a patient with clinical features of portal hypertension that ultimately proved to be multiple myeloma.