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Multiple system atrophy (MSA) is a neurodegenerative disorder characterized by autonomous insufficiency and motor abnormalities, such as akinetic rigid syndrome and cerebellar ataxia. The diagnosis of this disorder is challenging, and quite frequently the patients are seen by other specialties or with other diagnoses. The paper presents three clinical observations of patients with various phenotypic MSA subtypes. In two of them, the diagnosis of MSA was clinically proven and in the third one, clinically probable. All patients were initially followed up with other diagnoses. The authors describe specifics of complaints and past history registration, neurological examination and typical signs of MSA at neuroimaging.