Although previous reports have examined metamemory in various neurological groups, no study to date has examined various affective and cognitive contributors to metamemory collectively in a sample of multiple sclerosis (MS) patients. In the present study, 48 MS patients completed the Memory Functioning Questionnaire (MFQ) and were administered measures assessing depression, depressive attitudes, and executive functioning. Correlational analyses indicated that certain aspects of metamemory in MS were associated with both affective and executive variables. Structural equation modeling (SEM) analyses of three a priori models revealed the best fit with one model proposing that greater executive dysfunction and depression were associated with increased self-reported memory complaints, but via the mediating influence of depressive attitudes. Although our results suggest some objective basis for metamemory complaints in MS (i.e., executive dysfunction), they also suggest that these complaints may be exacerbated by the potentially reversible influences of depression and depressive attitudes. Treatment of depression and depressive attitudes in MS may result in MS patients having more accurate perceptions of their actual memory abilities that, in turn, may lead to improvements in their quality of life.