Chadi welcomes back Rafael Fonseca, (@Rfonsi1), MD, interim director of Mayo Clinic Cancer Center, and Aaron Goodman (@AaronGoodman33), MD, hematologist, University of California San Diego, to debate whether smoldering multiple myeloma should be treated. They begin by agreeing on a definition of the disease, listing patient characteristics that may warrant consideration for early intervention, and stating the importance of improving the ability to predict progressing disease. The trio then debate treatment in specific example circumstances and the overall consensus within the myeloma world, the practicality of clinical trials for smoldering disease, and so much more in this testy and thought-provoking dialogue.