**1. Introduction**

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system resulting in inflammation and demyelination in the brain and spinal cord. Although it is most commonly seen in adults, between 3–5% of patients have an onset of disease under the age of 18, and less than 2% of patients under 10 years of age [1–4]. Pediatric MS is rare, much less common than adult MS. The incidence of pediatric MS has been reported in ranges of 0.13 to 0.6 cases per 100,000 children per year [5]. Due to this, there have been fewer research, publications, and natural history data on pediatric MS. With the development of the International Pediatric MS Study Group (IPMSSG) in 2005, the knowledge base surrounding pediatric MS has increased. While the pathophysiology of the disease in the pediatric population is in line with that of the adult population, there are different challenges in the diagnosis, treatment, disease course, and clinical outcomes. In this review, we discuss the currently known environmental and genetic risk factors of pediatric MS, varying clinical presentations, diagnostic criteria and differential diagnoses, diagnostic evaluations, current treatment options, cognitive impairments and psychiatric comorbidity, disease course, and outcomes.
