The purpose of this narrative review is to define the theoretical constructs of engagement, participation, and balance. Besides, the implementation of these in MS-rehabilitation will be described, as symptoms as fatigue and cognitive decline may impact engagement in daily life. When studying the constructs of engagement and participation, they can be considered to be different. The constructs related to balance are of interest when targeting engagement. Multidisciplinary rehabilitation programs may have beneficial effects to optimize engagement. Hereby the measurement of these constructs is primordial as they give a deeper understanding in the meaning of activity performance, reflecting engagement in daily life. Future research may focus on the description of engagement in both men and women with MS at all stages and explore variables influencing engagement in daily life in order to integrate engagement optimization in MS rehabilitation. Engagement may have beneficial effects as part of the multidisciplinary rehabilitation in multiple sclerosis (MS).