Massimo Filippi, MD, Vita-Salute San Raffaele University, Milan, Italy, shares his perspective on using high-efficacy disease-modifying therapies (DMts) at the initial stages of multiple sclerosis (MS). It is established that MS treatment should be started as early as possible. Nowadays, the debate has changed to whether early treatment should also be high-efficacy treatment. Early initiation of high-efficacy DMTs may be the best strategy to delay irreversible neurological damage and progression of the disease. Moreover, high-efficacy DMTs may positively impact overall cost-effectiveness and healthcare systems sustainability. This interview took place at the 2022 Congress of the European Academy of Neurology (EAN) in Vienna, Austria.