Background <p>Development of a self-report measure of antecedents affecting coping with multiple sclerosis lead to the identification of influential factors in the coping process and the provision of health cares with a focus on providing or modifying these factors. The current study aimed to develop and validate the antecedents affecting coping scale for multiple sclerosis patients.</p> Methods <p>This methodological study was conducted in two stages. In the first stage, the concept of coping antecedents was explained using qualitative content analysis approach through interview with 11 MS patients, then the initial items were extracted and the questionnaire was developed. In the second stage, reliability and validation of the questionnaire were evaluated including face, content and construct validity. The76 items in primary items pool reduced to 24 items after evaluating validity and reliability.</p> Results <p>Factor analyses revealed 5 factors: social support, awareness about disease, personal opinion and attitudes, spiritual - religious beliefs, and economic - environmental factors. Internal consistency and stability of the developed questionnaire as well as respectively confirmed with 0.92 and 0.95.</p> Conclusion <p>The 24 items developed questionnaires is valid and reliable for measurement of antecedents affecting coping among multiple sclerosis patients in Iran.</p>