Background. Amyotrophic lateral sclerosis (ALS) is a disease of the parts of the nervous system that control voluntary muscle movement. In ALS, motor neurons (nerve cells that control muscle cells) are gradually lost. As this happens, the muscles they control become weak and then nonfunctional, thus leading to muscle weakness, disability, and eventually death. ALS is the most common form of motor neuron disease. Recent studies widely demonstrated that the pattern of progression in sporadic ALS patients is unsolved mystery, especially what factors influence the progression of the disease. Therefore, we conducted a study using ALS Functional Rating Scale-Revised (ALSFRS-R) for disease progression and investigated factors contributing to its rapid rate in The First University Clinic of Tbilisi State Medical University in 2019–2022. Materials and methods. A total of 60 patients with ALS were examined, among them 31 male (51.67 %), 29 female (48.33 %) aged 21–84 years. Riluzole takers, patients with sporadic ALS underwent brain magnetic resonance imaging, and electrophysiological studies were done in all patients. Participants were diagnosed using the Gold Coast criteria and examined with the ALSFRS-R. Survey for factors affecting disease progression was performed with a help of the patient’s caregiver (a disease-specific questionnaire was invented for this purpose, investigating probable progression modifiers). Results. It has been found that recent falls, trauma, surgery, and infection have a drastic impact on disease progression. ALS was found to be a not linear progressive disease and can vary. We have found that 5 % of patients had improvement оn ALSFRS-R, not explained by medication, nor lifestyle change. Conclusions. The rate of ALS progression appears to be a mystery by itself. Predicting the progression rate, and the factors affecting it would be beneficial for ALS patients and may even bring chances to slow or halt the progression. Further research is essential.