Background: Multiple sclerosis (MS) is the most common autoimmune demyelinating disease of the central nervous system (CNS). It is an inflammatory disease affecting mostly young adults that damages the myelin sheath that surrounds the nerves and results in a wide range of neurological symptoms. In recent years, major therapeutic improvements for MS have been described with the development of disease modifying therapies (DMTs). However, limited options are available for patients with highly active phenotypes of the disease. Objectives: The objective of this clinical case report is to highlight the benefit of alemtuzumab treatment in symptoms of highly active MS. Methods: None or not applicable Results: None or not applicable Conclusions: A case of a 41-year-old Hispanic female patient with a 20-year history of MS who demonstrated typical signs of highly active disease will be discussed. After multiple failed attempts at managing the disease with a variety of DMTs, the patient was started on alemtuzumab in 2016. The treatment led to significant improvement of clinical symptoms. Specifically, motor control and cognitive ability showed compelling progress. Reporting the findings of this case is essential due to the shortage of investigation of successful treatments in highly active disease. The discussion of this evidence will aid in decreasing the gap in knowledge about the benefits of alemtuzumab in highly active multiple sclerosis.