To evaluate routine blood count parameters as diagnostic and prognostic markers in Multiple Sclerosis (MS) progression. 182 patients with Relapsing-Remitting MS (RRMS) and 60 with Secondary Progressive MS (SPMS) were analyzed for blood parameters. In RRMS, the Expanded Disability Status Scale (EDSS) score correlated positively with Red Cell Distribution Width (RDW). In SPMS, the EDSS score correlated positively with White Blood Cell count (WBC) and Mean Platelet Volume (MPV). RDW predicted higher EDSS scores in RRMS, while MPV was a predictor in SPMS. Elevated MPV levels characterized the increased risk of transitioning from RRMS to SPMS. Elevated MPV may serve as a significant indicator of disease progression from RRMS to SPMS, emphasizing its potential clinical relevance.