Abstract Purpose To evaluate by Optical Coherence Tomography (OCT) the presence of peripapillary retinal nerve fiber layer (RNFL) damage in patients suffering from multiple sclerosis (MS). Methods Prospective study of the peripapillary RNFL measured by Stratus OCT in 116 eyes from 58 patients divided in four groups: non optic neuritis MS patients (non ON‐MS): 35 eyes; optic neuritis MS patients (ON‐MS): 20 eyes; fellow eye optic neuritis MS patients (FE‐ON‐MS): 29 eyes; healthy controls (HC): 32 eyes. Results The peripapillary RNFL thickness is lowered not only in eyes from patients with MS and ON (81'6±20'6µm), but also in their fellow eye 92'9±13'6µm), and even in eyes from MS patients without previous history of ON (101'0±11'2µm). p< 0,05, ANOVA test. Conclusion OCT proved to be a useful device in the diagnosis of axonal damage in patients with MS.