The European Committee of Treatment and Research in Multiple Sclerosis (ECTRIMS) and the European Academy of Neurology (EAN) have joined to develop an up-to-date and evidence-based clinical practice guideline for the pharmacological treatment of people with multiple sclerosis (MS) to guide healthcare professionals in the decision-making process. This guideline focuses on disease-modifying treatment (DMT) for the adult patients with confirmed MS and clinically isolated syndrome (CIS) and a total of 20 recommendations have been agreed, encompassing treatment efficacy, monitoring of treatment response, strategies for inadequate treatment response, treatment discontinuation and/or switch, as well as treatment in special situations (such as pregnancy). This paper presents the highlights of the guideline and gives some comments.