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The sNfL level between the 10th and 30th percentile was reflective of negligible MRI activity 1.4% (SET) and 6.5% (GeneMSA) of patients developed ≥3 active lesions, 5.8% (SET) and 6.5% (GeneMSA) developed ≥2 active lesions, and 34.8% (SET) and 11.8% (GeneMSA) showed ≥1 active lesion on brain MRI. The sNfL level less then 10th percentile was associated with even lower MRI activity. Similar results were found in a subgroup of clinically stable patients. CONCLUSIONS Low sNfL levels (≤30th percentile) help identify patients with MS with very l