To summarize the management experience of neurological symptoms in 11 patients with recurrent and refractory AQP4-IgG seropositive neuromyelitis optica spectrum disorder (NMOSD) treated with anti-BCMA CAR-T cell therapy. Methods: General nursing observation, management of cytokine release syndrome (CRS), neurological symptoms, psychological care, and timely rehabilitation management were implemented for 11 patients after infusion of anti-BCMA CAR-T cells. Results: During a median follow-up period of 5.5 months (range: 1～14 months), all 11 patients achieved drug-free remission without relapse after discontinuing all corticosteroids and immunosuppressants. Additionally, all 11 patients reported improvements in the Expanded Disability Status Scale (EDSS) and quality of life. Conclusion: Close observation and early detection of neurological symptoms after infusion, coupled with effective management, can alleviate patient suffering and ensure the successful clinical implementation of anti-BCMA CAR-T cell therapy for recurrent and refractory AQP4-IgG seropositive neuromyelitis optica spectrum disorder.