BACKGROUND Treatment of multiple myeloma has changed considerably over the last two decades with remarkable reduction in mortality rates in clinical trials and in population-based studies. Since health care systems and patient management differ between countries, population-based data from cancer registries with high coverage may provide further insight into real-life achievements and unmet needs. We report on the first population-based nation-wide study of incidence, mortality and survival of multiple myeloma in Switzerland covering the era of autologous stem cell transplantation and the first proteasome inhibitors and immunomodulatory drugs. METHODS We performed a retrospective registry study with data from the National Institute for Cancer Epidemiology and Registration (NICER) database in Switzerland from 1994 to 2013. RESULTS We identified 5770 patients with multiple myeloma. Incidence has increased from 419 new cases per year in 1994-1998 to 557 new cases per year in 2009-2013 while the age-adjusted incidence rate remained stable at 4.7-5.0 per 100'000 person-years. Five- and 10-year relative survival increased from 32.6% (95%CI 29.3-36.0) and 17.8% (95%CI 14.9-21.0) in 1994-1998 to 46.4% (95%CI 43.3-49.3) and 25.0% (95%CI 21.9-28.3) in 2009-2013. CONCLUSION The increase in incidence can be attributed to demographic changes. There is a trend to longer relative survival in all age groups with substantial increase in myeloma patients aged less than 75 years and only minimal changes in older persons.