<h4>Background</h4>Serum neurofilament light chain (sNfL) has emerged as a promising biomarker of neuroaxonal injury in multiple sclerosis (MS), but its prognostic value for clinical and radiological outcomes requires comprehensive synthesis of available evidence.<h4>Methods</h4>In this meta-analysis, we systematically searched PubMed, Embase, Ovid, and Cochrane databases from January 2015 to January 2026 for studies evaluating the association between baseline sNfL levels (high vs low) and MS progression outcomes. The gene discussed is NEFL; the disease is multiple sclerosis.