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Background and aims: The prevalence of multiple sclerosis in the Russian Federation varies from 10 to 80 people per 100,000 depending on the geographic area. Conduction of large-scale epidemiology studies is a promising approach in establishing risk factors that lead to a more severe disease course, as well as defining treatment needs in various country regions. In 2017, an electronic registry of adult patients with multiple sclerosis (MS) that live in Russian Federation was initiated. We present results of a three-year experience of maintaining a Russian e-Registry of patients with MS. Methods: The Russian MS e-Registry is a prospective multicenter non-interventional study with a retrospective analysis of available medical records at the time of the patient’s enrollment. A special individual registration form was created in order to collect both clinical, instrumental and epidemiological data. Results: Between December 2017 and December 2020, data on 3,028 patients with MS were collected. The following information was obtained: basic demographic statistics, extensive clinical data such as disease course and duration, diagnosis at the moment of symptom onset and time of confirmed diagnosis, number and nature of disease exacerbations, EDSS, use of disease-modifying therapies (DMTs) and switching between different DMTs; results of multiple laboratory findings, including oligoclonal bands in cerebrospinal fluid, and MRI data throughout the disease course. Conclusion: Our findings suggest that several major issues, such as delayed MS diagnosis and late initiation of DMT, as well as incorrect switching between different DMTs can contribute to earlier transition of relapsing-remitting MS to a secondary progressive course. Disclosure: The authors have no conflicts of interest to declare.