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Coping strategies have been shown to influence adjustment to life with multiple sclerosis (MS). Research on coping strategies used by MS patients have yielded contradictory results, possibly reflecting small sample size.To examine coping strategies in a large cohort of people with MS.Participants were recruited across the United Kingdom and completed a demographic questionnaire and Coping Orientations to Problems Experienced (COPE60) scale, clinicians provided clinical data. Analysis included multiple ordinal logistic regression.Among 722 patients with MS, the most commonly used strategy was Acceptance, followed by Active Coping, Planning and Positive Reinterpretation and Growth. The least common were Disengagement, Denial and Turning to Religion. Both demographic and disease characteristics independently predicted use of certain coping strategies. Females were twice as likely as males to use seeking social support and males were 1.6 times more likely to use Humour. Higher use of both behavioural and mental disengagement were associated with unemployed status, and disability. Substance use was 2.3 times as likely with relapsing as progressive MS and 1.9 times more likely in men.Awareness of these associations facilitates counselling for people with MS. Ongoing work examines the relation between coping and future quality of life.