Medication-related osteonecrosis of the jaws (MRONJ) is a major complication of antiangiogenic and antiresorptive treatment. We report a case of a male patient, 60 years old, diagnosed with multiple myeloma and treated with radiotherapy in the spine and zoledronic acid every 21 days. Oral evaluation showed good oral health with small mobility of tooth 24. After 14 doses of zoledronic acid, treatment was suspended due to oral complaint. The patient showed pain and suppuration in the area on tooth 24, which evolved to bone exposure 1 month later. Treatment included sequestrectomy and antibiotics, but exposure increased during the month, and more invasive surgery was planned. Two days before surgery, the patient reported a spontaneous exfoliation of the necrotic bone without suppuration and good clinical appearance in the area, and no other intervention was necessary. Spontaneous resolution of MRONJ with bone sequestration has a good outcome and reduces morbidity of a surgical procedure.