Multiple sclerosis (MS) is an autoimmune disorder affecting individuals in their reproductive years, significantly impacting physical, psychological, and socioeconomic well-being. Treating relapsing-remitting MS (RRMS) remains a challenge, as conventional therapies, though beneficial, lack robust efficacy in relapse rate reduction. Anti-CD20 therapy with Ocrelizumab is effective but poses significant financial burden, especially in resource-limited settings like India. Rituximab, a well established drug with similar mechanism, remains unapproved for RRMS despite its potential benefits. Our study aims to establish efficacy (reduction in Annual Relapse Rate, ARR as primary end point) and safety of Rituximab in RRMS and explore endophenotype variations in MS pathogenesis to optimize therapeutic strategies. RRMS patients with pre-determined eligibility criteria will be recruited from multiple centres and randomized into either the conventional therapy arm (as per institute protocol) or the Rituximab arm. Patients will be monitored at baseline, 30 ±10 days, 90±10 days, 180± 10 days, 365± 10 days and then every 180 days (if no clinical deterioration occurs). Serum samples will be analysed for CD4, CD8, CD56 and cell clustering done to classify endophenotypes, along with individual HLA typing. miRNA profiling would also be performed. We anticipate establishing Rituximab as non-inferior to conventional therapies, with study outcomes guiding future official treatment guidelines. Creation of database for endophenotypic profile in India and incorporating the same in RRMS treatment could lead to improved patient prognostication and therapy selection, exemplifying precision medicine. The study attempts to identify epigenetic modifications by miRNA profiling in RRMS patients and assess correlation with endophenotype variants.