Conventional MR imaging refers to techniques that are readily available and widely used in the diagnosis and monitoring of individuals with multiple sclerosis (MS). MR imaging is helpful in establishing an early diagnosis of MS after a single clinical event consistent with demyelination. A standardized imaging protocol is invaluable for diagnosis and monitoring disease evolution and response to treatment over time. The characteristic lesions of MS are varied and not always evident at the earliest stages of the disease. Furthermore, MR imaging is highly sensitive for detecting these lesions but remains pathologically nonspecific. Careful communication among clinicians and radiologists will optimize the interpretation of important abnormalities on MR imaging.