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In recent decades, multiple sclerosis (MS) diseases have been significantly prevalent in some industrial areas of Iran, such as steel industrial areas in Isfahan province (central Iran). In this study, the environmental impacts of two steel mill factories in Isfahan province and their effects on the spread of MS in the region were investigated. To examine the extent of exposure, seasonal dust samples were collected from 15 sites around the two investigated factories. The annual dust deposition rate (DDR) was then determined and the concentrations of lead (Pb), cadmium (Cd), nickel (Ni), cobalt (Co), and manganese (Mn) in the dust samples were measured. Furthermore, the concentration of the mentioned elements was determined in the nail samples taken from 40 MS patients and 40 healthy people (control) living in the study region. The interpolated map extracted from the DDR values showed the highest dust deposition around the two studied steel factories, which decreases with increasing distance from them. The enrichment factor (EF) of heavy metals was the highest at the distance between the two steel factories, decreasing by moving away from them which indicate that these two steel factories are the source of investigated heavy metals in the region. The statistical analysis also revealed significant differences (P < 0.01) between the concentration of heavy metals measured in nail samples taken from MS patients and healthy people. The mean Pb concentration measured in the nail sample taken from MS patients was more than 18 times that of healthy people (93.45 and 5.02 mg/kg, respectively). These results revealed a buildup of heavy metals in the body of MS patients much more than usual, originating from the activities of two investigated steel companies in the region., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)