Although new disease-altering treatments offer hope for those with multiple sclerosis, they are not appropriate for most. Management of symptoms, however, can help everyone with the disease. Several new therapies, including tizanidine, intrathecal baclofen, botulinum toxin injections, gabapentin, ondansitron, thalamic stimulation, and lamotrigine, increase our treatment options. Better understanding of the sleep disorders that commonly occur in those with multiple sclerosis will help us treat another disabling symptom. This chapter reviews the medical and surgical management of multiple sclerosis symptoms, including these new options.