The effects of trace elements have been investigated in multiple sclerosis (MS) etiology for years. However, common results have yet to be obtained in previous studies. Therefore, as a cross-sectional case–control study, we aimed to examine the relationship between trace elements and MS in the Konya province, where air pollution is intense. Study participants with MS were investigated regarding the expanded disability status (EDSS) and multiple sclerosis functional composite (MSFC) scales. All study participants were also evaluated concerning the Beck Depression Inventory (BDI), Facit Fatigue Scale (FFS), Fatigue Severity Scale (FSS), and levels of blood chromium (Cr), manganese (Mn), copper (Cu), zinc (Zn), selenium (Se), cadmium (Cd), and lead (Pb). While there were 49 people in the MS group, 51 individuals constituted the controls. Mn, Zn, Cd, and Pb levels were significantly higher in controls. There was no significant difference between MS and control groups regarding depression and fatigue scores. MSFC parameters, depression, and fatigue scale scores were statistically higher with increasing EDSS in MS patients. A significant correlation was also observed between the scores of the timed 25-foot walk (T25FW) and dominant hand 9-hole peg test (9HPT) and Cr levels (p = 0.014, 0.004). A relationship was also observed between Mn levels and T25FW (p = 0.047). Trace element levels can be seen at different levels in MS patients. While a correlation was observed between some MSFC parameters and Cr and Mn levels, no relationship was observed between trace element levels, depression, fatigue, and EDSS.