OBJECTIVES Multiple Sclerosis (MS) is an immunomediated, highly disabling disease affecting young adults. The demographic characteristics, disease modifying therapies and health resources utilization by patients followed at a MS reference center in Sao Paulo, Brazil are presented. METHODS Patient's charts were reviewed from a retrospective cohort of 353 MS patients. Patients were selected by attendance to outpatient visits at Hospital das Clínicas, Faculty of Medicine - University of Sao Paulo from March to May 2008. RESULTS From 353 patients, 74% were female and 86% were white-Caucasians. A positive family history was identified in five patients. Sixty-eight percent had relapsing-remitting MS, 13% secondary progressive MS and 10% primary progressive MS. Half of the patients had MS diagnosis for less than 5 years. At the last interview, 226 patients (64%) were on immunomodulatory agents. From these, 59 patients were using glatiramer acetate and 167 were using beta-interferons. The immunomodulatory drug was changed in 11 patients. Sixty-one patients (17%) were on immunossupressants, with 31% using azathioprine. Average EDSS score at last visit was 4.2. Approximately 24% of patients had at least one relapse requiring treatment and 5% were hospitalized in the last 12 months. CONCLUSIONS There are few data on epidemiology and health resource use published in Latin-American countries, while many countries like Brazil provide high-cost treatments at public health system. In our study, the current approved MS therapies were widely used. Therefore, the understanding of local patients' characteristics and health resources use can provide data for an optimized, tailored disease management solutions in these countries.