The role of self-care in the management of chronic illnesses is essential to successful patient care. This paper compares and contrasts self-initiated self-care practices of 51 Danish and 35 American persons with multiple sclerosis at various levels of disability. Respondents were asked about ways they managed their symptoms and problems during periods of non-medical contact--including methods of following the medical regimen; alternative treatments; use of lay-referral systems; and, sources of information regarding physical, psychological, social, and environmental dimensions of coping with the illness. The two groups of respondents varied regarding adaptation strategies and primary sources of information used. The ultimate aim, however, of using these strategies was similar; to gain control over uncertainty, dependency, and physical and emotional decline. This study suggests that the empowering role of self-initiated self-care strategies in chronic illness may transcend differences in health care systems.