Background: Multiple sclerosis (MS) can occur in pediatric age group with prevalence rates ranging from 2.2%-4.4% of all MS cases. This research conducted to compare adult multiple sclerosis with pediatric multiple sclerosis clinically and radiologically and to assess similarities and differences between them. Methods: 30 MS patients divided into 2 groups (Group A aged 18 years or more at first presentation, group B less than 18 years) underwent detailed history taking, general , neurological examination, MRI brain for location and number of lesions and disability assessment using Expanded Disability Status Scale. Results: No significant difference between the two groups as regard duration of first attack, frequency between monosymptomatic to polysymptomatic and complete to partial to no improvement from first attack and percentage of frequency of each of all MRI locations. Conclusion: Pediatric and adult MS are similar as regard presentation ,progression and localization.