Background Although several studies indicated that the prevalence of pediatric multiple sclerosis (MS) is approximately 5% of the adult MS cohort, reports on clinical features of pediatric MS is scarce in our region. Objective To study the demographics and clinical characteristics of MS patients whose disease started before the age of 17 years. Methods Utilizing the national MS registry, we conducted a cross-sectional study to identify MS patients who had their disease onset before 17 years of age. Demographics and clinical characteristics (age, age at onset, symptoms presentation at onset, disease duration, disease course, relapses, expanded disability status scale (EDSS), and use of disease modifying therapies (DMTs)) were collected. Results Records of 111 pediatric MS patients were analyzed; of whom 71.2% were females. Mean age at onset and mean disease duration were 14.85 and 9.49 years respectively. Family history was reported in 12.6%. Supratentorial, optic pathway, cerebellar/brainstem, and spinal symptoms were the presenting symptoms in 28.8%, 23.4%, 35.1%, and 27% of patients respectively. 14.4% of patients presented with multifocal symptoms at onset. Most of the patients (82%) had relapsing remitting course, while clinically isolated syndrome group constituted 8.1%. The mean number of relapses was 3.36 and the mean EDSS at last visit was 2.51. Most of the patients (75%) had EDSS less than 4. The mean time to secondary progressive MS in 9.9% of the patients was 14.63 years. Of 79.08% patients who were exposed to DMTs, 13.51% had aggressive course necessitating the use of natalizumab as a first line therapy while 37.36% escalated to second line therapies during their disease course. Conclusions MS patients with pediatric-onset had comparable clinical characteristics to adult onset MS. Most patients had low EDSS scores despite the relatively higher percentage of patients with initial aggressive course and breakthrough disease throughout their disease course. Although several studies indicated that the prevalence of pediatric multiple sclerosis (MS) is approximately 5% of the adult MS cohort, reports on clinical features of pediatric MS is scarce in our region. To study the demographics and clinical characteristics of MS patients whose disease started before the age of 17 years. Utilizing the national MS registry, we conducted a cross-sectional study to identify MS patients who had their disease onset before 17 years of age. Demographics and clinical characteristics (age, age at onset, symptoms presentation at onset, disease duration, disease course, relapses, expanded disability status scale (EDSS), and use of disease modifying therapies (DMTs)) were collected. Records of 111 pediatric MS patients were analyzed; of whom 71.2% were females. Mean age at onset and mean disease duration were 14.85 and 9.49 years respectively. Family history was reported in 12.6%. Supratentorial, optic pathway, cerebellar/brainstem, and spinal symptoms were the presenting symptoms in 28.8%, 23.4%, 35.1%, and 27% of patients respectively. 14.4% of patients presented with multifocal symptoms at onset. Most of the patients (82%) had relapsing remitting course, while clinically isolated syndrome group constituted 8.1%. The mean number of relapses was 3.36 and the mean EDSS at last visit was 2.51. Most of the patients (75%) had EDSS less than 4. The mean time to secondary progressive MS in 9.9% of the patients was 14.63 years. Of 79.08% patients who were exposed to DMTs, 13.51% had aggressive course necessitating the use of natalizumab as a first line therapy while 37.36% escalated to second line therapies during their disease course. MS patients with pediatric-onset had comparable clinical characteristics to adult onset MS. Most patients had low EDSS scores despite the relatively higher percentage of patients with initial aggressive course and breakthrough disease throughout their disease course.