Nurse practitioners in primary care settings are on the first line to recognize motor, sensory, and cognitive deficits that may help establish a diagnosis of MS. While referral to a neurologist is often made, patients with chronic illnesses such as MS often return to the primary care setting for management. In their multi-faceted roles of administrators, educators, collaborators, consultants, researchers and advocates, nurse practitioners are in a position to help identify and manage relapses, symptoms and treatment-related side effects that all can affect the course of the disease.