Background <p>Multiple sclerosis (MS) impairs balance control, affecting mobility and quality of life. Virtual reality (VR) offers a novel way to study balance mechanisms and potential rehabilitation. This review examines balance control in MS patients using VR, comparing responses in VR and non-VR settings with those of healthy controls.</p> Methods <p>This systematic review adhered to PRISMA guidelines. Comprehensive searches were conducted across databases including PubMed, Web of Science, Scopus, CINAHL, and ScienceDirect. Studies involving individuals with MS were analyzed to explore population characteristics and types of VR environments employed. Data extraction focused on participant demographics, clinical profiles, VR configurations, and reported outcomes.</p> Results <p>The potential value of VR training in this population was explored via systematic review. 23 studies highlighted the potential of VR environments to explore balance mechanisms in MS. Diverse VR types, ranging from immersive to semi-immersive systems, were used to assess postural control, functional balance outcomes, gait, and mobility. Despite variability in methodologies and reported outcomes, changes in functional measures such as gait and balance were frequently observed. This variability underscores the need for standardized protocols to enhance the comparability and application of VR in MS rehabilitation.</p> Conclusion <p>This systematic review highlights the variability in assessed balance response outcomes in PwMS.</p>