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Data on the prevalence of Multiple Sclerosis (MS) in Tunisia come back more than twenty years ago. Our study aimed to determine the prevalence of MS in Tunisia and to discuss the determining factors of its current status. The results suggested a trend towards an increase in the prevalence of MS in Tunisia reaching 58.3 per 100 000 inhabitants in 2020. It ranks Tunisia in a high prevalence MS zone but is still lower than that in the western countries and some MENA countries. The determining factors of this new MS prevalence need to be investigated to insure better management of healthcare resources.