The growing adoption of Apple Silicon for machine learning development has created demand for efficient inference solutions that leverage its unique unified memory architecture. However, existing tools either lack native optimization (PyTorch MPS) or focus solely on text models, leaving multimodal workloads underserved. We present vllm-mlx, a framework for efficient LLM and MLLM inference on Apple Silicon built natively on MLX. For text models, we achieve 21\% to 87\% higher throughput than llama-cpp across models ranging from Qwen3-0.6B to Nemotron-30B, while providing continuous batching that scales to 4.3x aggregate throughput at 16 concurrent requests. For multimodal models, we introduce content-based prefix caching that eliminates redundant vision encoding by identifying identical images through content hashing, regardless of input format. Our evaluation on Apple M4 Max demonstrates throughput of up to 525 tokens per second on text models and 28x speedup on repeated image queries, reducing multimodal latency from 21.7 seconds to under 1 second. Video analysis with up to 64 frames achieves 24.7x cache speedup. We release our implementation as open source to support efficient inference on consumer Apple hardware.