Over the past 10 years, 7 Tesla (7T) MRI has brought many advances in the in vivo exploration of the pathophysiological mechanisms of multiple sclerosis (MS). Thanks to increased signal-to-noise ratio and contrast-to-noise ratio, as well as increased spatial resolution (voxel size below 500 µm 3), 7T MRI provides access to precise anatomical details, not or barely visible at 3T MRI, some of which being strongly associated with MS prognosis. Although routine use of 7T imaging is still limited due to cost, engineering time required, and technical challenges (more severe B0 and B1 inhomogeneities compared to lower field strength, long scan time), it is very likely that 7T MRI will soon be an additional tool to guide clinical practice.