We sought to better understand the relationship between atrophy along the entire spinal cord and disease burden in multiple sclerosis using MRI. Towards this, we analyzed spinal cord cross-sectional area in 48 healthy control and 250+ subjects clinically diagnosed with various phenotypes of multiple sclerosis. Our results show cervical cord atrophy early in the onset of the disease, which correlated with clinical measures of disease severity. However, these correlations were reduced as the disease progressed. Such studies may help in better understanding of disease progression and can play a role as an imaging marker in clinical trials.