Over the past two decades, the understanding and management of multiple sclerosis (MS) have advanced dramatically, reshaping long-held views of the disease. MS is now increasingly seen as a continuous spectrum rather than a condition with distinct phases, with evidence showing it can begin silently, even before clinical symptoms emerge. Technological and diagnostic innovations have enabled the detection of early brain changes and biomarkers, opening doors to earlier diagnosis and intervention. New diagnostic criteria allow MS to be identified without a clinical event, and studies on disease-modifying therapies (DMTs) support the benefits of early treatment. A major shift in treatment strategy is also underway, emphasizing early, aggressive approaches and therapies that target progression rather than just relapses, which are no longer seen as the main driver of long-term disability. A pivotal development in MS research is the confirmation of Epstein–Barr virus (EBV) as a fundamental trigger of the disease, with new evidence pointing to specific viral protein regions as higher-risk factors. Despite these strides, MS research remains a dynamic and evolving field, with much still to be uncovered beneath the surface.