BACKGROUND Multiple Sclerosis (MS) is also known as encephalomyelitis disseminate, is a white matter disease of brain and spinal cord. It has an extremely variable clinical course and relapsing remission in nature. MS onset usually occurs in young adults females. MS can present with any neurological symptoms or signs, involving motor and sensory systems. The diagnosis of MS in Asian population, particularly in Pakistan, is still debatable. Different techniques including history and clinical examination are initial investigations but the advancement of MRI techniques has revolutionized the early detection and treatment of MS considering its type and the course of the disease. OBJECTIVES The object of this study is to characterize MS lesions, particularly in temporal lobes and its impact on cognitive impairment. MATERIALS AND METHODS This study was conducted in the Radiology Department of King Edward Medical University/Mayo Hospital, Lahore after approval from ethical committee. Patients from all affiliated departments of Neurology & Medicine in the Lahore city Hospitals, encatchment areas where MRI facilities were available in the hospitals in the Punjab province were analyzed. All collected data was analyzed by SPSS version 17. RESULTS: The minimum age was 18 years while maximum age was 65 years with mean age of 43.07 ± 13.88 years. It was more common in females (57 %) as compared to males. MS is associated with different factors including smoking (19%), Alcohol-intake (2%) and Viral Infections (8%). Clinically are most of the patients present with weakness and numbness (53%) and (69%) respectively. However another significant presentation is blurring of vision i.e. about 48%. MS plaque is predominantly supratentorial region of brain (97%) however infratentorial entity is also present (16%). It can involve deep white matter, periventricular and juxtacortical region of temporal lobe and more frequent in periventricular(96%) and deep white matter(95%) and they are detected efficiently on T2WI and flair sequences. Musculoskeletal and vision disturbance is strongly associated with MS plaques. CONCLUSION: MS is disease of young to middle age predominantly in females causing musculoskeletal and sensory neural complications diagnose efficiently on T2WI and flair MR sequences.