Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. The underlying pathology can be both inflammatory and degenerative. It affects over 400,000 Americans per year and usually strikes in the prime of life. The disease can result in serious and debilitating impairment of physical, emotional, and cognitive functions that limit patients' overall status, halt their hopes and dreams, and alter their quality of life. To slow disease progression, administration of disease-modifying treatments early in the course of disease is thought to offer the best option for patients to achieve safe and effective management of this lifelong condition. This strategy, along with symptomatic management, encompasses the newest philosophy of comprehensive MS care. From an evidence-based understanding of MS, the role of the MS nurse has been transformed from a supportive, educative role to that of a highly skilled, knowledgeable and specialized professional. The nurse is a lynchpin in a multidisciplinary team dedicated to a patient's continuing care. In addition, the role of the MS nurse has evolved to incorporate supervising MS clinical trials, monitoring patients, implementing protocols, evaluating outcomes, and ultimately contributing to evidence-based practice. Although it is important that patients receive the appropriate therapy that may slow disease progression and manage symptoms, the individualized support provided by the MS nurse is essential to the sustained use of long-term treatments. Industry-supported nurse-administered patient assistance support programs, such as the Betaseron Education, Training and Assistance Nurse/BETAPLUSTM, MS Lifelines, Shared Solutions, and Avonex Services, employ nurses who offer valuable emotional, educational, and technical support to MS patients, ensuring that their needs are met throughout the course of therapy. These MS nurse specialist programs impart knowledge about self-administration of injections and facilitate self-management to reduce adverse events and promote sustained adherence. Regular contact with patients, a consistent level of care, a trusting relationship, and a greater understanding of prescribed treatment have resulted in increased adherence to complex protocols. As the specialty of MS nursing continues to evolve within the MS healthcare team, the MS nurse will continue to have a profound influence on treatment and improving quality of life in patients with MS.