In this review, we summarize advances in knowledge derived from the application of magnetic resonance imaging (MRI)-based techniques to patients with multiple sclerosis (MS) published in the Journal of Neurology over the past year. We highlight the pivotal role played by conventional MRI techniques for a correct and early diagnosis of this condition and the exclusion of alternative disorders. Advanced MR methods have contributed to demonstrating how damage to selected brain structures is related to disease clinical manifestations, thus contributing to overcome the well-known "clinical-radiological" paradox of MS, and ameliorating the understanding of the mechanisms underlying the accumulation of irreversible disability. Finally, we discuss the use of MRI to assess treatment efficacy and optimize therapeutic approaches in this condition.