Rituximab and demyelinating diseases have been studied extensively in multiple-sclerosis (MS) centers worldwide, yet regional data from low- and middle-income countries remain limited. In Pakistan, where disease-modifying therapies are often unaffordable, early recognition and timely treatment can reduce long-term disability. This study presents real-world experience from a tertiary academic center providing integrated neurological and immunologic care for patients with demyelinating disorders of the central nervous system (CNS).