To determine whether MS patients differ from healthy subjects in stress-related immune changes, we examined immunologic alterations following a public speaking task in 25 MS patients and 25 healthy controls. Both groups demonstrated similar autonomic, neuroendocrine and immunologic responses to acute stress. Neutrophils, monocytes, CD8+ suppressor/cytotoxic T-lymphocytes and NK-cells transiently increased, with parallel changes in NK-cell activity. T-cell proliferation declined at 20 min, followed by increased reactivity at 60 min relative to baseline. This data suggests that stress-induced immune alterations remain intact in MS patients, and may contribute to immune changes associated with disease exacerbation.