Multiple sclerosis (MS) poses a complex challenge, impacting countless individuals worldwide. The disease's multifaceted pathogenesis has stymied researchers and clinicians. Yet, headway has been made in understanding its immunological roots, leading to novel therapies like Anti-CD20 Monoclonal Antibodies (mAbs) that target B cells. These mAbs offer a precise approach to immune modulation, holding the potential to arrest disease progression and reduce relapses. This review delves into the efficacy, mechanisms, and safety of Anti-CD20 mAbs in MS treatment. Clinical trials consistently demonstrate their effectiveness in lowering relapse rates, slowing disability progression, and enhancing patients' quality of life. While concerns about infections exist, safety data support their viability. Comparative analysis of mAbs like rituximab, ocrelizumab, ofatumumab, and ublituximab unveils their unique mechanisms and dosing regimens. For long-term success, treatment optimization is paramount, balancing sustained disease control with safety monitoring, personalization, and quality of life considerations. Combining mAbs with existing or emerging therapies shows promise. Looking ahead, precision medicine, cellular therapies, and digital health technologies promise to revolutionize MS care. This review equips clinicians, researchers, and stakeholders with a comprehensive understanding of Anti-CD20 mAbs potential in MS management and envisions an era of tailored therapies and innovation in MS treatment.