Objective. To demonstrate the experience of a personalized approach to the treatment of pediatric patients with multiple sclerosis using the example of the Moscow patient population. Materials and methods. The authors describe the clinical follow-up of 79 pediatric patients with demyelinating diseases of the nervous system during 2019, including 39 patients with multiple sclerosis, including one patient with a primary progressive course of the disease (clinical case). Results. The experience of the Moscow office for the treatment of multiple sclerosis in children and adolescents demonstrates the effectiveness of the personalized approach to the treatment of pediatric cases confirmed by the case report of biological therapy by recombinant humanized monoclonal antibody directed against CD20-expressing B-cells for early treatment of the adolescent patient with primary progressive multiple sclerosis. Conclusion. The identification of patient’s groups with different levels of disease activity and different risks of disability progres-sion is highly relevant in the pediatric population of patients with multiple sclerosis, especially in the context of expanding therapeutic opportunities. © 2020, Media Sphera Publishing Group. All rights reserved.