Multiple sclerosis (MS), the most common cause of neurological disability in young adults, represents the prototypic inflammatory autoimmune disorder of the central nervous system. Increased understanding of the immunopathological processes underlying this disease, advances in biotechnology, development of powerful magnetic resonance imaging technologies together with improvements in clinical trial design have translated into a variety of new and innovative therapeutic avenues. In this review, we will highlight recent therapeutic developments in MS and critically discuss new challenges associated with these new treatment options.