<p><strong>Background: </strong>Massive open online course (MOOC) research is an emerging field; to date, most research in this area has focused on participant engagement.</p> <p><strong>Objective: </strong>Here, we evaluate both participant engagement and measures of satisfaction, appropriateness and burden for a MOOC entitled Understanding Multiple Sclerosis (MS) among a cohort of 3,518 international course participants.</p> <p><strong>Methods: </strong>We assessed the association of key outcomes with participant education level, MS status, caregiver status, sex and age using summary statistics, t-tests and chi square tests.</p> <p><strong>Results: </strong>Our key findings were: (1) the course was well received, with 97% of participants satisfied, with an appropriate pitch and low burden (a mean of 2.2 hours engagement per week); (2) people living with MS were less likely than those not living with MS to complete the course; (3) caregivers and participants without a university education were more likely to apply the material by course completion.</p> <p><strong>Conclusions: </strong>The Understanding MS MOOC is fit for purpose; it presents information in a way that is readily understood by course participants and is applicable in their lives.</p>