This study characterized gray-matter (GM) multiple sclerosis (MS) lesions using double-inversion recovery (DIR), contrast-enhanced and diffusion at 3T MRI. Lesion segmentation was based on DIR. We determined GM lesion prevalence, characterize their contrast-enhancement and diffusion characteristics, and compared them with white-matter (WM) lesions. Correlated GM lesion count and volume with total brain, WM, GM and deep GM volumes, as well as clinical disability. Comparisons were also made with healthy controls. We tested the hypothesis that GM MS lesions are highly prevalent, contrast-enhanced GM lesions have higher ADC values, and GM MS lesion counts and volumes are correlated with brain atrophy.