Background <p>Emotion regulation is a multidimensional construct that is robustly linked to emotional disorders yet remains underexplored in multiple sclerosis (MS), with no studies to date addressing individual differences in emotion regulation difficulties in this population. To address this gap, the current study used latent profile analysis (LPA) to identify distinct profiles of emotion regulation difficulties in an MS sample.</p> Methods <p>Participants were 259 people with MS (<i>M</i>_age = 42.79, 78.8% female). Participants completed an online survey measuring emotion regulation difficulties and symptoms of depression, generalized anxiety disorder (GAD), health anxiety, and posttraumatic stress disorder (PTSD). Emotion regulation was specified as the indicator variable in the LPA, with the additional measures of depression and anxiety utilized to validate the identified profiles.</p> Results <p>Three emotion regulation profiles were identified: <i>low impairment</i> (n = 66, 25.48%) characterized by minimal difficulties regulating negative emotions across all domains; <i>global dysregulation</i> (n = 71, 27.41%) characterized by pronounced difficulties in all domains; and <i>goal-impaired regulators</i> (n = 122, 47.10%) characterized by distinct challenges maintaining goal-directed behaviors. Individuals in the <i>global dysregulation</i> profile endorsed the greatest symptom severity on measures of depression and PTSD but reported comparable levels of GAD and health anxiety relative to the <i>goal-impaired regulators</i>.</p> Conclusion <p>People with MS exhibit distinct patterns of emotion regulation difficulties, revealing critical subgroups with varying psychological needs.</p>