Multiple myeloma (MM) is the second most common haematological malignancy and is an incurable disease of neoplastic plasma cells (PC). Newly-diagnosed MM patients currently undergo lengthy genetic testing to match chromosomal mutations with the most potent drug/s to decelerate disease progression. With only 17% of MM patients surviving 10-years post diagnosis, faster detection and earlier intervention would unequivocally improve outcomes. Here, we show that the cell surface protein desmoglein-2 (DSG2) is overexpressed (gene and protein) in approximately 20% of bone marrow biopsies from newly-diagnosed MM patients. Importantly, DSG2 expression was strongly predictive of poor clinical outcome, with patients expressing high levels of DSG2 exhibiting an almost 3-fold increased risk of death. Preliminary mouse studies also suggest that targeting DSG2 attenuates MM growth and disease progression. As a prognostic factor, DSG2 is independent of (i) genetic subtype, (ii) routinely measured biomarkers of MM activity (e.g. paraprotein) and (iii) therapy received. Functional studies revealed a non-redundant role for DSG2 in adhesion of MM PC to endothelial cells. Together, our studies suggest DSG2 to be a cell surface biomarker that can be readily detected by flow cytometry to rapidly predict disease trajectory at the time of diagnosis.