Mucous membrane pemphigoid (MMP) is a potentially life-threatening autoimmune disease in the case of laryngeal, conjunctival, tracheal, or esophageal involvement. Current therapeutic options include topical corticosteroids, dapsone, sulfasalazine, tetracycline, and a variety of systemic immunosuppressive medications, but the condition remains refractory in some cases. Rituximab is a genetically engineered chimeric anti-CD20 monoclonal antibody that has been successfully used to treat autoimmune antibody-mediated diseases. In this case series, Le Roux-Villet et al demonstrate a rapid and dramatic efficacy for rituximab in treating 25 patients with severe, refractory MMP. The occurrence of severe infections in patients receiving concomitant immunosuppressants supports using rituximab as monotherapy.