ObjectivesWe compared work disability of patients with multiple sclerosis (MS) from 5 years before with 5 years after diagnosis, with that of matched controls, and analysed whether progression in work disability among patients with MS was associated with sociodemography.DesignPopulation-based cohort study.SettingThe adult Swedish general population.ParticipantsResidents aged 24–57 diagnosed with MS (n=3685) in 2003–2006 and 18 425 matched controls without MS.Primary and secondary outcome measuresAnnual net days of sickness absence (SA) and disability pension (DP), used as a proxy for work disability, followed from 5 years before to 5 years after diagnosis (ie, T−5–T+5). For patients with MS, regression was used to identify sociodemographic factors related to progression in work disability.ResultsWork disability of patients with MS increased gradually between T−5 and T−1 (mean: 46–82 days) followed by a sharp increase (T+1, 142 days), after which only a marginal increase was observed (T+5, 149 days). The matched controls had less work disability, slightly increasing during the period to a maximum of ∼40 days. Men with MS had a sharper increase in work disability before diagnosis. High educational level was associated with less progression in work disability before and around diagnosis.ConclusionsPatients with MS had more work disability days also 5 years before diagnosis. Several sociodemographic variables were associated with the absolute level and the progression in SA and DP.