Treatment of patients with multiple sclerosis, despite the availability of many therapies, remains a challenge. The introduction of ocrelizumab, a highly effective therapy, has significantly improved the control of disease activity. The article discusses four different cases of patients treated with ocrelizumab, including one patient with newly diagnosed relapsing-remitting multiple sclerosis, one case of treatment modification after ineffective first-line therapy, and two cases of long-term follow-up of patients with primary progressive multiple sclerosis. The review of case studies is complemented by magnetic resonance images and the results of tests evaluating treatment effectiveness. In all clinical situations discussed, ocrelizumab proved to be the optimal choice. In addition to inhibiting the clinical and radiological progression of the disease in the long term, it was very well tolerated by patients.