In the sanatorium in Vráz near Pisek in 1970-1978 3310 patients with multiple sclerosis received spa treatment. By analysis of their birth place, domicile at age of 15 years and present domicile we tried to assess the geographical distribution of the disease in Czechoslovakia. The area of the suspected highest frequency of MS is the northwestern part of Bohemia with the maximum near Teplice and Most. The lowest frequency was recorded in the lowland areas of southern Moravia and southern Slovakia including Bratislava. The frequency gradient from the north-west towards the south-east, the demarcation line formed by the 49th northern parallel and some ecological relations are very striking and deserve further research and confirmation.