<p>Multiple sclerosis (MS) is a chronic, immune-mediated, neurodegenerative disease of the central nervous system (CNS) characterized by inflammation, demyelination, and axonal destruction. MS impacts about 2.6&#xa0;million individuals worldwide, typically presenting a wide array of clinical manifestations, such as motor, sensory, visual, and dementia, often leading to progressive disability. This progressive condition and the accumulation of handicaps draw attention to a crucial unmet need for therapies able to preserve neurons, encourage myelin regeneration, and restore neurological function. Although present conventional treatments mostly target the inflammatory aspects of MS, their effectiveness in treating the underlying neurodegeneration and supporting central nervous system repair is still limited. Recently, stem cell-based therapy and regenerative medicine have become some of the most promising approaches for treating MS. However, progress is subject to challenges and achievements are limited. The current study thoroughly investigates the findings of preclinical and clinical studies on neural stem cell (NSC)-based therapies for MS and highlights the related challenges. Study investigates its possible modes of action, treatment effectiveness, major earlier challenges, and emerging questions in transferring NSC-based therapies into clinical practice, aiming to improve neuroprotection, promote remyelination, and facilitate the repair of damaged CNS tissue. NSC-based therapies hold great potential as a regenerative therapy for MS, however, fundamental questions remain about the optimal delivery, long-term survival, functional integration, and potential immunological responses. To sum up, NSC-based therapies represent a promising new frontier in the next generation of treatments for MS. However, further comprehensive studies are required to conclusively confirm their safety, effectiveness, and long-term advantages.</p>