Multiple sclerosis (MS) is an autoimmune neurodegenerative disorder of the central nervous system (CNS). A significant percentage of MS patients will develop neuropsychiatric symptoms during their lifetime; affective symptoms are most common, but psychosis is reported in approximately 1% of patients. Atypical antipsychotics are commonly prescribed for treatment of psychotic symptoms and a recent case report demonstrated the benefit of oral aripiprazole 10 mg in treating paranoid-hallucinatory psychosis in a patient with MS. We report on a 46-year-old African-American female diagnosed with MS who was admitted with delusional and paranoid behavior. She had no history of mental illness and had a negative urine drug screen on admission. Following 3 days of treatment with oral aripiprazole, the patient became more cooperative with hospital staff, took her prescribed medications, and demonstrated a reduction in paranoid behavior and delusional thinking. She was discharged on oral aripiprazole 10 mg twice daily. This case report suggests the benefit of aripiprazole for psychotic symptoms in MS. Further study of aripiprazole's efficacy is needed to confirm these findings.