The 2024 McDonald Criteria now include the optic nerve as the fifth topography for dissemination in space. Optical coherence tomography (OCT) is a valuable biomarker for the diagnosis, prognosis and monitoring of multiple sclerosis (MS). A panel of MS neurologists from 19 centres across 9 Latin American (LATAM) countries discussed OCT use, access, standardized protocols and research potential. They found inequities in OCT access between private (80%) and public healthcare (44%). Only 9 centres had standardized protocols, 50% of which followed the OSCAR-IB consensus criteria for retinal OCT quality assessment and 53% had a neuro-ophthalmologist. The panel concluded that OCT should be available in all MS centres and that standardized acquisition and reporting, as well as improved knowledge of OCT use, in clinical practice are necessary. OCT has significant research potential in LATAM that requires further development and implementation.