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Purpose: To determine whether speech-evoked auditory brainstem response (ABR) is more sensitive to the effects of multiple sclerosis (MS) than click-evoked ABR., Materials and Methods: Eleven previously-confirmed MS patients (8 females, 3 males) and nine controls (7 females, 2 males), matched in age and gender, participated in a repeated-measures design. Stimuli were presented monaurally to the right ear via insert earphone. All evoked potential responses were collected by a single-channel montage where three electrodes were placed on the center of the head (Cz: non-inverting/ active), the ipsilateral earlobe (inverting/ reference) and the contralateral earlobe (ground). Rarefaction clicks of 0.1 ms duration were presented at rates of 13.30 and 91.1 clicks per second. Speech-evoked ABRs were obtained using the BioMARK software and the Bio-Logic Navigator PRO hardware. A synthesized /da/ syllable of 40-ms duration was presented via alternating polarity and at a rate of 10.9 stimuli per second. Stimuli were presented at 80 dB SPL. Speech-evoked ABR responses were obtained in quiet and in noise., Results: Conventional click ABR responses were absent more often at high presentation rates in control subjects than in MS patients. Speech-evoked ABR peak amplitudes, wave E latency and VA complex slope variables separated the MS patients from controls. Group differences were also found in speech-evoked ABR response correlations in quiet versus noise conditions., Conclusions: The speech-evoked ABR is as or more sensitive to MS than conventional ABR measures without resort to simply noting missing peaks. Comparison of speech-evoked ABR responses in quiet and in noise highlight loss of neural synchrony in MS., (Copyright © 2020 Elsevier B.V. All rights reserved.)