The deposition of paramyloid in mesenchymal tissue occurs in approximately 10% of patients with plasmacytic myeloma. Clinically significant involvement of the gastrointestinal tract by paramyloid is infrequent. A patient with plasmacytic myeloma demonstrated extensive paramyloid deposition which produced both malabsorption and small bowel obstruction. The marked similarity of the paramyloidosis of plasmacytic myeloma and "primary" systemic amyloidosis is contrasted with the dissimilarity of paramyloidosis and the secondary amyloidosis associated with chronic disease. There is emphasis on the necessity of adequate bone marrow examination in patients with the clinical manifestations of "primary" systemic amyloidosis.