Background: Multiple sclerosis (MS) is the most common progressive neurologic disease all over the world. MS is an immune-mediated disease and there is contradictory data regarding cardiovascular morbidity and mortality risk factors in MS patients. Objective: To assess the body composition in MS patients, and to explore the associations of anthropometric indices and metabolic risk factors with the phenotypic features of MS. Patients and Methods: a cross-sectional study included 150 patients fulfilling the diagnostic criteria for MS according to the revised McDonald’s criteria 2010, and 145 age and sex-matched healthy controls. Fat mass index (FMI) and free fat mass index (FFMI) were assessed by dual-energy X-Ray absorptiometry (DEXA). Results: This study was conducted on MS patients with phenotypes; RRMS (82%) and SPMS (18%). our results revealed that the distribution of body composition among MS patients was 30 %, overweight was 48% and lean was 22%. Also, MS patients had significantly higher values of systolic and diastolic blood pressure as well as dyslipidemia, obesity indices, and hs-CRP compared to the control group, P-value < 0.001. Interestingly, there were significantly higher values of the expanded disability status scale (EDSS), dyslipidemia, obesity indices, and hypertension in the obese group compared to other groups. Conclusions: MS patients had higher values of dyslipidemia and obesity indices than control groups. Among MS, the prevalence of overweight patients was higher than lean and obese MS patients.