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Risk stratification in smoldering multiple myeloma (SMM) is evolving beyond baseline clinical parameters—such as M-protein levels, bone marrow plasma cell infiltration, and free light chain ratios—to include dynamic biomarkers that reflect disease progression over time. This lecture will highlight the widely adopted “2/20/20” model, which identifies high-risk SMM based on M-protein >2 g/dL, bone marrow plasma cells >20%, and a free light chain ratio >20. These advancements in risk assessment are critical for identifying patients at highest risk of progression to symptomatic myeloma, enabling timely and potentially disease-modifying early intervention.