There is an increasing appreciation that multiple sclerosis (MS) can affect children. Up to 10% of MS patients experience their first symptoms before the age of 16. The natural history and magnetic resonance imaging of MS in child-hood differ from those observed in adult patients. The differential diagnosis of MS in children should also encompass some paediatric diseases. Recently, the diagnostic criteria for MS in children were published. Due to the high frequency of relapses and the risk of disability at a young age, early diagnosis and treatment of MS in children is very important. This work presents recent data regarding epidemiology, pathogenesis and diagnosis of MS in children, including the role of neuroimaging in the diagnosis of childhood multiple sclerosis.