Although there is no definitive cure for multiple sclerosis, immunomodulatory agents developing since the mid 1990’s have surfaced and produced beneficial effects in decreasing relapse rate and, some agents more than others, reducing disability progression. These group of drugs are termed “Disease modifying therapy” and it mostly benefit patients with a multiple sclerosis of a relapsing and remitting course. However, choosing an agent out of the big arsenal of disease modifying therapy is not always easy and in fact it poses a challenging prospect for the treating physician. The initial treatment agent should be chosen according to the patient’s preference, convenience and values, without a guarantee that this treatment will be tolerated by the patient.