Introduction. High-dose immunosuppressive therapy with autologous hematopoietic stem cell transplantation (HDIT/AHSCT) is a promising and effective method for treating immune disorders, including multiple sclerosis (MS). The frequency and severity of adverse effects from therapy have decreased significantly over the last 20 years due to a reduction in conditioning regimen intensity, changes in patient selection, and the accumulated experience of the transplantation centres. Study aim: to analyse the published data on HDIT/AHSCT complications in MS and ways to reduce their risk. Materials and methods. We analysed and summarized the research findings regarding conditioning regimen protocols for HDIT/AHSCT, early and late complications, and risk factors associated with treatment recipients. Results. HDIT/AHSCT may have a wide range of serious complications. However, the shift to less intense conditioning regimens and stricter patient selection criteria have minimized adverse events. The latest moderate-intensity protocols may be less effective than high-intensity protocols, but their timely use may provide the maximum benefit to people with MS refractory to standard treatment. HDIT/AHSCT cannot be the method of choice for all categories of patients with MS, because expectations may not be met due to the significant risk of complications, in particular, in cases of long-term disease, significant neurological deficit, and no disease activity. The maximum effect should be expected in early or emergency HDIT/AHSCT. Conclusion. This information can be used to justify further expansion of the medical assistance provided to patients with MS in the Russian Federation.