OBJECTIVES: To describe inpatient resource use among multiple sclerosis (MS) patients within the Brazilian public healthcare system (BPHS). METHODS: Inpatient admissions were obtained from the Brazilian Hospital Information System Database for the period 2006-2009. Records were included if an ICD-10 code G35 (MS) appeared as primary or secondary reason for hospitalization. The following variables were collected: procedure code for the inpatient admission (relapse management versus other indications), mean length of stay, mean Intensive Care Unit (ICU) days, in-hospital mortality, mean cost per hospitalization. Hospitalization rates were calculated using the estimated MS population under treatment in the BPHS (estimated from pharmacy claims). Relapse-related admissions were separately analyzed. RESULTS: Annual hospitalizations due to MS were 2,142 in 2006, 2,268 in 2007, 1,648 in 2008, and 1,689 in 2009. The hospitalization rates among MS patients attending BPHS facilities decreased from 0.60 in 2006 to 0.28 in 2009. Among all admissions, 91.7% were relapse-related in 2006 with similar proportions in 2007 and 2008, and a slightly decrement in 2009 (88.0%). The in-hospital mortality rate is generally low, with the highest value in 2008 (3.09%) and the lowest in 2009 (1.6%). There were no differences between relapse-related and non-relapse-related admissions in terms of in-hospital mortality. The mean length of stay was 8.9 days for all MS-related hospitalizations and 7.7 days for those to manage MS. ICU claims were rare in this sample. In 2009, the observed average cost per hospitalization was 675 BRL and the total expenditure with MS inpatient admission was 1,140,418BRL (corresponding to 0.53% of pharmaceutical expenditures due to MS). CONCLUSIONS: Relapses are responsible for over 90% of all inpatient admissions of MS patients. Although higher health resource consumption is expected in the outpatient setting, therapeutic strategies directed at reducing the incidence of relapses can potentially lead to savings within the BPHS.