Background: Limited data are available on the prevalence of multiple sclerosis (MS) in central Italy. The objective of this study is to estimate MS prevalence in the metropolitan area of Rome. Methods: We used the capture-recapture method to calculate prevalence estimates in the study area. The selected prevalence day was December 31, 2015. A total of 1,007 patients, with a definite diagnosis of MS according to the revised McDonald’s criteria, were considered for crude, age- and sex-specific prevalence estimation. Results: The overall crude prevalence rate was 146.2 cases per 100,000 (95% CI 119.9–172.5). A higher prevalence rate was recorded in females (194.1, 95% CI 149.6–238.6) than in males (93.0, 95% CI 67.2–118.8) with a female to male ratio of 1.8. Age-specific prevalence peaked in the 25–34 , 35–44 and 45–54 years class; moreover, it was found to increase up to the 45–54 years age group in females and the 35–44 years age group in males, decreasing thereafter. Conclusion: The results confirm that the metropolitan area of Rome is a high-risk area for MS.

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