Introduction. Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system that leads to disability, primarily affecting young people. In the Russian Federation, especially in the northern regions with low population density, the accessibility of specialized neurological care remains extremely limited. This is due to the remoteness of medical facilities, a shortage of qualified personnel, a lack of diagnostic equipment, and challenging climatic conditions. The high prevalence of multiple sclerosis in the Arctic and Siberian regions is exacerbated by social factors such as isolation, alcoholism, and vitamin D deficiency. Goal. To analyze contemporary literature data on the problems of organizing neurological care for patients with multiple sclerosis in the northern regions of Russia and to propose optimization pathways using telemedicine technologies and digital monitoring tools. Materials and Methods. The literature review was based on an analysis of scientific publications from 2020 to 2024 concerning the organization of neurological care for multiple sclerosis patients in low-population-density regions. The search for sources was conducted in international databases (PubMed, Scopus) and the Russian database eLibrary using keywords: "multiple sclerosis", "рассеянный склероз", "telemedicine", "remote regions", "Arctic", "healthcare accessibility", "remote monitoring", "federal registry", "rehabilitation". Results. It was established that the northern regions of the Russian Federation experience a high incidence of multiple sclerosis against a backdrop of systemic problems: a shortage of Magnetic Resonance Imaging (MRI) machines, a lack of specialized specialists, and difficult access to modern medications and rehabilitation. Vitamin D deficiency, harsh climate, and social isolation further worsen the disease prognosis. The implementation of telemedicine, a federal patient registry, and remote condition monitoring are recognized as key directions for improving continuity of care, early diagnosis, and timely therapy adjustment. Conclusion. Improving the accessibility and quality of care for multiple sclerosis patients in the northern regions requires a comprehensive approach, including the development of telemedicine consultations, the creation of a unified electronic database, training for local medical staff, and ensuring remote monitoring of patients' conditions. This will help reduce the time to diagnosis, optimize treatment, and improve the quality of life for patients in hard-to-reach areas.