Introduction: This study aimed to explore how the lifeworld of Iranian patients with multiple sclerosis is constructed, transformed, and reinterpreted within their specific sociocultural and spiritual context, recognizing that the lived experience of chronic illness transcends biomedical dimensions.

Methods: A qualitative interpretive metasynthesis was conducted using Sandelowski and Barroso’s (2007). Twenty-five Iranian qualitative studies (2011–2024) were systematically reviewed. Data were analyzed via MAXQDA 2022; trustworthiness was ensured through triangulation, peer debriefing, and Cohen’s kappa (0.738).

Results:The main components of lifeworld were identified :: (1) Bodily: “Adversarial body,” chronic pain, bodily distrust, and fear of disability; (2) Psychological: existential anxiety, identity disruption, yet resilience (3) Social: role renegotiation within family, social withdrawal, and structural tensions with healthcare systems; (4) Spiritual: reliance on religious beliefs for reinterpretation of suffering, trust in divine wisdom, and pursuit of purpose.

Conclusion: The lifeworld of Iranian MS patients is a dynamic and multidimensional construct. Findings call for holistic interventions that integrate identity reconstruction, community support, and spiritually sensitive dialogue.