Satralizumab is a monoclonal anti-IL6-anibody for patients with neuromyelitis optica or neuromyelitis optica spectrum disorder (NMOSD) seropositive for anti-AQP4-antibody. Satralizumab has been approved in 2021 in the Russian Federation for usage in adults and adolescents from 12 years and older in combination with basic therapy or in monotherapy. The efficacy and safety of satralizumab in comparison with placebo have been demonstrated in two international randomized clinical trials SakuraStar and SakuraSky, phase III. We present clinical experience with satralizumab gained in frames of the Compassionate Use Program that have been initiated in Russia for NMOSD patients. Here, we summarized the results of treatment with satralizumab of 16 patients (14 men and 2 women), aged 13—69 years. Duration of therapy was 9 to 41 week. The first experience of using satralizumab in the Russian Federation in the small group of patients does not yet allow us to draw conclusions about the efficacy due to the short follow-up period. It can be concluded that the safety profile of satralizumab is consistent with the results obtained in international clinical trials. The experience gained in the ongoing program allows us to conclude that satralizumab is a valuable and convenient therapeutical option for seropositive for anti-AQP4-antibodies patients with NMOSD.