Multiple sclerosis (MS) is the most common neurological disorder of young adults in Germany. It is associated with significant medical, social and economic consequences. Aim of this study was to assess the epidemiology of MS and to describe the healthcare resource utilization and costs for MS compared to patients without MS from a statutory health insurance (SHI) perspective. This was a retrospective cohort study utilizing claims data of a large German health insurance. Prevalent MS patients in 2013 were identified using ICD-10-GM codes as well as ATC codes and matched to a control group of patients without MS. Matching parameters included age, gender, state of insurance, Elixhauser Comorbidity Index, federal state and residence in urban/rural areas. Demographic characteristics, healthcare resource consumption and healthcare costs were determined for 2013. Statistical differences between the groups were assessed using paired tests. In 2013, 24,150 prevalent MS patients were identified. The age- and gender-adjusted prevalence rate was 416.6 per 100,000. Extrapolated to the German population, 335,440 patients suffered from MS. After the matching process 22,492 MS patients remained, of which 80.3% were female and the mean age was 52.7 years. Differences in healthcare consumption between the groups were most notable in the inpatient, aids, devices, and care-giving sector. The total costs from the SHI perspective were €14,240 per MS patient and €4,214 per control group patient (p<0.001). The difference was mainly due to medication costs (€7,336 vs. €1,075, p<0.001) and care-giving expenses (€2,143 vs. €241, p<0.001). The age- and gender-adjusted prevalence in this study was considerably higher than described in literature. Resource consumption of MS patients was significantly increased compared to the control group, especially concerning the inpatient, care-giving and pharmaceutical sectors. This was also reflected in the substantially higher costs per patient.