OBJECTIVES: Spasticity and fatigue are common in patients with Multiple Sclerosis (MS) and can highly affect patients’ quality-of-life (QoL). A burden-of-disease study was performed to gain real-life data on MS-related fatigue and the patients’ and physicians’ evaluation of fatigue and QoL.  METHODS: The MOVE 1 (MObility ImproVEment) study included a cross-sectional investigation of fatigue and QoL of MS spasticity patients, using the “Würzburger Erschöpfungsinventar bei Multipler Sklerose” (WEIMuS, German MS-related fatigue questionnaire) and the EQ-5D QoL instrument. WEIMuS total score (0-68; cut-off ≥32), cognitive (0–36; cut-off ≥17) and physical (0–32; cut-off ≥16) fatigue subscores are obtained. EQ-5D includes 5 domains (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) with 3 answer levels (no, some and extreme problems).  RESULTS: In total, 419 MS patients with spasticity were enrolled at 42 German centres from 4/2011 to 9/2011. 414 patients fulfilled selection criteria and were analyzed. Mean age was 48.6 (± 9.6) y., 64.3% were female. According to physicians, 27.3% of patients had mild, 44.0% moderate and 28.7% severe spasticity. Fatigue was recorded by physicians in 49.4% and by patients in 50.0% of cases as one of the most disturbing spasticity associated symptoms. According to WEIMuS, total fatigue cut-off score was reached by 48.0%, 53.8% and 54.5% of patients with mild, moderate or severe spasticity; while physical fatigue was observed in 52.9%, 69.6% and 66.3% and cognitive fatigue in 37.3%, 35.7% and 37.6% of these subgroups, respectively. With increasing spasticity severity the mean EQ-5D index value decreased (0.6±0.2 to 0.3±0.3) and the number of patients with “extreme problems” raised, particularly in the domains “mobility” (0% to 13.6%), “self-care” (1.0% to 20.0%) and “usual activity” (2.9% to 25.5%).   CONCLUSIONS: The occurrence of fatigue in MS patients increases with spasticity severity, impairing patients’ QoL in parallel. Patients’ and physicians’ evaluations are aligned.