OBJECTIVES: The mobility impairment associated with multiple sclerosis (MS) may have an impact on employment status, work productivity, indirect costs, and health-related quality of life (HRQoL). We estimated indirect costs and HRQoL (utilities) of MS patients in the United States (US). METHODS: The North American Committee on Multiple Sclerosis (NARCOMS) registry was used to conduct a cross-sectional study of participants who completed the biannual update and supplemental Spring 2010 surveys. Demographic, employment status, income, mobility impairment, and health utility data were collected from registry participants who agreed to participate in the Mobility Study. Mean annual indirect costs per participant in 2011 USD and mean utilities for the population and for cohorts reporting different levels of mobility impairment were estimated. The Patient Determined Disease Steps, NARCOM’s mobility Performance Scale score, and question 1 of the 12-item Multiple Sclerosis Walking Scale were used to define levels of mobility impairment.  Indirect costs were estimated using the human capital approach and utilities using the EuroQol 5-Dimension. RESULTS: Analyses included 3433 to 3616 participants, depending on survey completeness. Most participants were women (80.1%), ≥40 years of age (80.7%), and had MS for ≥10 years (84.9%).  A total of 20.3% of participants experienced a relapse in the past 6 months and 40.4% were receiving a disease-modifying drug; 32% were not working or attending school.  Total indirect costs per participant per year were estimated to be $21,680±20,730. The largest relative increases in indirect costs occurred at earlier impairment stages, regardless of the mobility impairment measure used. Participants’ mean utility score (0.73±0.18) was lower than that of a similarly aged sample from the general US population (0.87). As with indirect costs, the largest declines in utility were seen at earlier mobility impairment stages. CONCLUSIONS: Mobility impairment may contribute to increases in indirect costs and declines in HRQoL in MS patients.