BACKGROUND Adequate risk knowledge of people with Multiple Sclerosis (pwMS) is a prerequisite for informed choices in medical encounters. Previous work showed that MS risk knowledge is low among pwMS and role preferences are different in Italy and Germany. OBJECTIVE We investigated the level of risk knowledge and role preferences in 8 countries and assessed putative variables associated with risk knowledge. METHODS An online-survey was performed based on the Risk knowledge questionnaire for people with relapsing-remitting MS (RIKNO 2.0), the electronic Control Preference Scale (eCPS), and other patient questionnaires. RESULTS Of 1939 participants from Germany, Italy, the Netherlands, Serbia, Spain and Turkey, 986 (51%) completed the RIKNO 2.0, with a mean of 41% correct answers. There were less than 50 participants in the UK and Estonia and data were not analysed. Risk knowledge differed across countries (P < .001). Variables significantly associated with higher risk knowledge were higher education (P < .001), previous experience with disease modifying drugs (P = .001), correct answer to a medical data interpretation question (P < .001), while higher fear for wheelchair dependency was negatively associated to risk knowledge (P = .001). CONCLUSIONS MS risk knowledge was overall low and differed across participating countries. These data indicate that information is an unmet need of most pwMS. CLINICALTRIAL Not applicable.