In Russian Federation in 2022, the Expert Council adopted the main definitions and terms for neuromyelitis optica spectrum disorders (NMOSD) and proposed a treatment algorithm for patients with NMOSD with antibodies to aquaporin-4 (AQP4-IgG). The publication is intended to present the results of the work of the Russian Expert Council in September 2024. The experts agreed on clarifications of previously published terminology, new definitions, current issues in the therapy of NMOSD, proposed profiles of patients with NMOSD for ravulizumab and a monitoring plan during treatment with this drug, and agreed on an updated algorithm for prescribing medications that prevent exacerbations in patients with NMOSD with AQP4-IgG aged 18 years and older.