Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. The disability and cognitive impairment caused by MS cause a great economic burden on patients and society. Early prediction and understanding of the development direction of the disease are helpful to improve the treatment plan. With the development of imaging technology, the understanding of the changes of the central nervous system caused by MS is more comprehensive and detailed. More and more studies have focused on observing the atrophy of various parts of the brain through imaging technology, so as to explain its correlation with the accumulation of disability and cognitive impairment. This article reviews the relationship between brain atrophy and disability and cognitive impairment from five parts: cerebral cortex, thalamus, basal ganglia area, cerebellum, and brain stem.