Objective: We investigated occupational risk of multiple myeloma (MM) in a pooled analysis of five international case-control studies. Methods: We calculated the odds ratio and its 95% confidence interval for selected occupations with unconditional regression analysis in 1959 MM cases and 6192 controls, by pooling study-specific risks using random-effects meta-analysis. Exposure to organic solvents was assessed with a job-exposure matrix (JEM). Results: Gardeners and nursery workers combined, most likely exposed to pesticides, showed a 50% increase in risk (OR. =. 1.50, 95% CI 0.9-2.3), while other farming jobs did not. Metal processors (OR. =. 1.55, 95% CI 0.9-2.3), female cleaners (OR. =. 1.32, 95% CI 1.0-1.8), and high level exposure to organic solvents (OR. =. 1.38, 95% CI 0.96-1.8) also showed moderately increased risks. Conclusions: Additional case-control studies of MM aetiology are warranted to further investigate the nature of the repeatedly reported increase in MM risk in several occupational groups. © 2013 Elsevier Ltd.