Pain is frequently evident in the course of multiple sclerosis (MS) and is estimated to occur in approximately 50% of patients. The incidence of pain has no apparent correlation to disease severity. Moreover, a comprehensive definition of pain has not been established, thus making the evaluation of this chronic, evolving symptom difficult. On the basis of its pathophysiology, pain can occur as a consequence of neurological impairment and disability, somatic pain or because of neurological damage. Although there are few randomized trials for pain in MS, new therapeutic strategies are now available and interest in the symptomatic treatment of MS is growing.