Open access. The Journal of Neurology, Neurosurgery & Psychiatry brought together a panel of experts on World MS Day 2017 to discuss the importance of time in MS—timing of initiation and withdrawal of disease-modifying treatment, time to consider contributory factors such as vascular disease, and the time and cost burden of MS. This paper, which originated in the round table discussion, reviews the following: latest thinking in timing of disease management; how treatment and prevention of vascular injury may buy additional time for people with MS; new data about the true economic and social burden of the disease for people with MS and their carers.