Multiple sclerosis (MS) is an autoimmune inflammatory demyelinating disease. Neuroinflammation, oxidative stress, demyelination, and apoptosis are important pathogenesis of MS. The phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway is closely related to the above pathophysiological processes. Currently, the immunosuppressive treatment for MS mainly focuses on disease-modifying therapies, aiming to reduce relapse rates and short-term exacerbations. However, it cannot cure the disease. With in-depth research into the pathological mechanism of MS, new pathogenic mechanisms and therapeutic targets urgently need to be explored. This paper takes“multiple sclerosis, PI3K/Akt signaling pathway, inflammatory response, oxidative stress, apoptosis”s keywords and retrieves relevant literature from the“Pubmed, China National Knowledge Infrastructure, and Web of Science”databases between 2004 and 2024. It reviews the research progress on the relationship between the PI3K/Akt signaling pathway and MS neuroinflammation, oxidative stress, demyelination, and apoptosis, aiming to provide new ideas for the treatment of MS.