Mark Freedman, MSc, MD, CSPQ, FAAN, FRCPC, University of Ottawa & Ottawa Hospital Research Institute, Ottawa, Canada, discusses a recently published review of recent investigations into the efficacy and safety of autologous hematopoietic stem cell transplantation (AHSCT) in patients with highly active multiple sclerosis (MS). Since AHSCT removes and replaces the entire immune system, it can overcome the immune mechanisms responsible for the disease. Therefore, transplantation can stop disease activity, avoid worsening disability, and prevent the need for ongoing disease-modifying treatment. Questions remain regarding which comorbidities increase the risks associated with AHSCT, as well as the optimal protocol. This interview took place during the ACTRIMS Forum 2021.