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Introduction Seizures occur more commonly in people with Multiple Sclerosis (pwMS) than in the general population. We characterize a population-based cohort of pwMS/CIS and seizure(s).Methods The South Wales MS registry was used to identify all people with MS/CIS and a history of seizure living in Cardiff and Vale between 2006-2023; the prevalent population was calculated on the 1st January 2020 for the catchment area. MR brain images nearest to time of first seizure were reviewed and compared to a matched cohort of pwMS without seizures.Results We identified 49 historical cases of co-existent MS/CIS and seizure(s). On 1st January 2020 we found that 2.4% (23/950) of the prevalent population of people with MS/CIS had experienced a seizure and 2.1% (20/950) had a diagnosis of epilepsy. Seizures occurred before other symptoms of MS in 15/49 and after MS in 34/49. One patient experienced seizure during MS relapse. Analysis of MR brain images suggests that PwMS and seizures have a higher number of T2 lesions and more marked brain atrophy.Conclusion This study suggests that approximately 2.4% of people with MS are expected to experience seizure(s). Seizures in MS are associated with higher overall brain disease burden.chjwood.medic@gmail.com