OBJECTIVES: Although it is well-recognized that people with multiple sclerosis (MS) may experience impairments in addition to limited mobility, there has been little effort to study the relative importance of such impairments.  This study assessed patient and neurologist preferences for MS treatment. METHODS: We surveyed MS patients and neurologists to estimate the value each group places on treating specific MS symptoms.  MS patients were asked about their own preferences, whereas neurologists were asked to consider what a patient of theirs would do or think in each scenario.  Each respondent was presented with two randomly selected scenarios with different symptoms and treatments and asked about patients’ willingness to pay (WTP) for the treatments.  Our analytic sample included 587 responses from 290 MS patients and 317 responses from 119 neurologists. RESULTS: To treat mobility alone, WTP for MS patients averaged $410 to $520 per month, depending on the scenario.  For paired symptoms, MS patients would pay most to treat mobility and upper limb function ($525/month) or mobility and cognition ($514/month), somewhat less to treat mobility and eyesight ($445/month), and least to treat mobility and fatigue ($371/month).  Patient WTP values increased with income and education.  Neurologists believed their patients would be willing to pay $216 to $249 per month to treat mobility alone, depending on the scenario.  For paired symptoms, neurologists believed patients would pay most to treat mobility and fatigue ($263/month) and least to treat mobility and upper limb function ($177/month). CONCLUSIONS: Our findings suggest MS patients may value one outcome (e.g., improved arm and hand coordination) over another (e.g., less fatigue).  Further, MS patients and neurologists may rank the importance of treating various symptoms differently.  Given this potential mismatch, it is crucial for MS patients and their clinicians to discuss treatment priorities that take into account patient preferences.