: Background: Illness representations (based on Leventhal's model) are associated with chronic illness outcomes. It has been suggested that targeting these cognitive components improves illness outcomes. Multiple sclerosis is a common disorder between neural and immune systems that creates physical and psychological consequences. There are few pre psychological trails on these patients. The aim of this study was to determine effectiveness of cognitive-behavior therapy on altering illness representations and improving emotional states of the patients. Methods: By using a randomized controlled trial design, among 52 selected patients, 35 volunteers randomly were allocated into intervention and control groups. An extensive interventional cognitive behavior therapy based package was conducted to intervention group in 10 weekly sessions. The control group stayed in waiting list and participated in 5 group meeting sessions. (IPQR) and (DASS-42) psychological scales were administered, Leven and T statistical tests were applied for dat analysis. Results: The results showed positive changes in four illness representation components of patients including illness (identity, consequences, coherence) and personal control. Associated improvement occurred in depression, anxiety, stress and emotional representations. Conclusion: Mooney and Padeskey's theoretically based cognitive-behavior therapy, is effective on illness representations modification and improving emotional states of the patients. The findings are less similar to Goodman's trial on Systemic Lupus Erythematosus patients and more similar to Petrie's trail on cardiac patients.