BACKGROUND: In recent years, significant progress has been made in immune demyelinating disorders, particularly regarding early diagnosis and disease-modifying drugs (DMDs). Despite advancements, socioeconomic factors in many Latin American countries present unique challenges that impede the proper identification and management of these disorders. OBJECTIVES: The updated consensus from the Central American and Caribbean working group strives to enhance the management of Multiple Sclerosis (MS), Neuromyelitis Optica Spectrum Disorder (NMOSD), and Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) by offering a framework for incorporating available treatment into clinical practice. METHODS: The authors conducted an extensive bibliographic search and followed a consensus process that included input from forum members to present a new, revised, and finalized report. RESULTS: The consensus, endorsed by over 70% of members, covers the application of DMDs, biologic agents, glucocorticoids, definitions of therapeutic failure, patient monitoring, cessation of treatment, prognosis, therapy use during pregnancy and lactation, and vaccination in patients initiating or on DMDs or biologic treatments. CONCLUSION: The revised consensus and guidelines aim to enhance long-term outcomes in these regions by assisting patients, regulatory bodies, healthcare providers, and policymakers.