The consensus report outlines the diagnostic criteria for multiple system atrophy (MSA), a progressive neurodegenerative disease affecting both sexes and typically beginning in middle age. The disease is characterized by parkinsonism, cerebellar ataxia, autonomic dysfunction, and corticospinal dysfunction. The diagnosis of MSA requires one criterion plus two features from separate domains. Probable MSA is defined by autonomic failure/urinary dysfunction plus poor levodopa-responsive parkinsonism or cerebellar ataxia. Definite MSA diagnosis requires pathological confirmation. The report emphasizes the importance of clinical assessment, with laboratory tests supporting the diagnosis. Key features include orthostatic hypotension, parkinsonian symptoms, cerebellar ataxia, and corticospinal signs. The report also provides guidelines for distinguishing MSA from other conditions and recommends specific terminology to avoid confusion.The consensus report outlines the diagnostic criteria for multiple system atrophy (MSA), a progressive neurodegenerative disease affecting both sexes and typically beginning in middle age. The disease is characterized by parkinsonism, cerebellar ataxia, autonomic dysfunction, and corticospinal dysfunction. The diagnosis of MSA requires one criterion plus two features from separate domains. Probable MSA is defined by autonomic failure/urinary dysfunction plus poor levodopa-responsive parkinsonism or cerebellar ataxia. Definite MSA diagnosis requires pathological confirmation. The report emphasizes the importance of clinical assessment, with laboratory tests supporting the diagnosis. Key features include orthostatic hypotension, parkinsonian symptoms, cerebellar ataxia, and corticospinal signs. The report also provides guidelines for distinguishing MSA from other conditions and recommends specific terminology to avoid confusion.