The western part of Norway has been a low-to medium-frequency area for multiple sclerosis (MS). The prevalence of definite/probable MS on January 1, 1961, was 24.3/100,000 in the county of Møre and Romsdal, western Norway. Based on the same diagnostic criteria, the prevalence of definite/probable MS increased to 75.4/100,000 on January 1, 1985. The average annual incidence rate increased from 1.94/100,000 in the period 1950-1954 to 3.78/100,000 from 1975-1979. Remitting MS in the younger age groups of both sexes increased the most. We consider this increase of MS to be due to alteration in exogenous factors as variation in genetic susceptibility cannot account for the increase in the stable western Norwegian population. The rise in prevalence/incidence over the last 20 to 25 years in western Norway supports the theory that MS is a disease influenced by exogenous factors that show variation over time.