Objective:To determine whether the prevalence of multiple sclerosis (MS) varies by race and ethnicity.Methods:We conducted a retrospective cohort study of more than 2.6 million adults from the multiethnic, community-dwelling members of Kaiser Permanente Southern California. The complete electronic health record of individuals with at least one ICD9 code for MS between January 1, 2008 to December 31, 2010 were reviewed. MS prevalence and 95% confidence intervals (CI) stratified by age-, sex- and race and ethnicity among 2010 members were estimated using binomial regression. Age- and sex-standardized prevalence was estimated according to the 2010 US Census population.Results:We identified 3863 patients with MS. The average age of prevalent MS patients was 51.7 years (standard deviation, 13.1) and 76.8% were women. The female preponderance was more pronounced among Black (81.2%) and Asian (83.6%) than White (76.3%) or Hispanic (74.5%) individuals with MS. Age- and sex-standardized MS prevalence per 100,000 was similarly high among Black (225.8, 95%CI=207.1-244.5) and White (237.7, 95%CI=228.2-247.2) and significantly lower among Hispanic (69.9, 95%CI=64.4-75.5) and Asian persons (22.6, 95%CI=17.1-28.1). MS prevalence was highest between the ages of 35 and 64 years and declined after 65, across all racial and ethnic groups. Among adults ages 18-24, crude MS prevalence was low, but was highest among Black and Hispanic young adults, lower in White and lowest in Asian/PI individuals (48.5, 25.0, 18.0 and 7.1/100,000, respectively).Conclusions:MS prevalence varies by race and ethnicity, being similarly high in White and Black and significantly lower in Hispanic and Asian persons in Southern California. Taken together with previous studies, these findings indicate that the burden of MS in the US Black community has long been under-recognized. More studies are needed to determine whether MS is an emerging disease among US Hispanic adults and whether MS susceptibility and prevalence vary among Hispanic or Asian individuals from different cultures and/or ancestral backgrounds.