High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation is the one of the effective therapy for patients with multiple myeloma. The aim of our study was to investigate the efficacy and safety of romiplostim support at autologous hematopoietic stem cell transplantation in multiple myeloma patients. Ten patients with multiple myeloma underwent autologous hematopoietic stem cell transplantation with romiplostim support (romiplostim group). All the patients received 250 μg of the thrombopoietin receptor agonist romiplostim on day of hematopoietic stem cell reinfusion. Thirty patients with multiple myeloma were assessed as a control group (without romiplostim support). The duration of grade 4 thrombocytopenia was 4.0 days for romiplostim group and 7.4 days for the control group (p = 0.003). Time to platelet count >25×10⁹/l was 10.4 days for romiplostim group and 13.0 days for the control group (p = 0.002). Platelet transfusion volume was 980 ml for romiplostim group and 1376 ml for the control group. Safety and efficacy of romiplostim support at autologous hematopoietic stem cell transplantation in multiple myeloma patients had proven by reduced risk of bleeding and cost minimization.