Objectives: Fatigue is the most common and disabling symptom for people with multiple sclerosis (MS) and female gender is correlated with higher reported fatigue severity. This study analyzes fatigue severity in adult women with MS and identifies significant differences between centers on mean fatigue severity scores. Methods: We conducted a prospective 1-year baseline study across four MS-CQI centers (A,B,C,D). Participants were adult females (18+) with MS. Fatigue severity was measured using the Promis Fatigue MS Patient-Reported Outcome Measure (PROM). Descriptive statistics were evaluated for each center, as well as significance testing across and between centers. Continuous variables were analyzed using ANOVA, and categorical variables were analyzed using Chi-Square tests. Results: 322 female MS patients were in the sample. 211 (65.5%) were white, 118 (36.6%) had full-time employment, 165 (51.2%) were married, 85 (26.4%) had an annual income of $50,000-$99,999, 222 (68.9%) were English-speaking, 27 (8.4%) lived alone, and 265 (82.3%) had employer health insurance. Socioeconomic variables demonstrating statistical significance (Chi-Square p,0.0001) included race, employment, marital status, language, housing, insurance and education. Significant center-level variation were also found compared to overall MS-CQI mean fatigue severity (ANOVA F=7.31, p,0.0001). Tukey's Honest Significant Difference tests (HSD) revealed statistically significant differences (p,0.0001) between centers C-B, D-B, A-B, B-C, B-D, and B-A (Critical Value=3.65). Conclusions: Results suggest significant center-level differences in mean fatigue scores across and between centers. Future research is needed to investigate the factors influencing these differences and test the effects of targeted center-level improvement interventions on reducing population fatigue severity levels.