The onset of action of hormone-resistant rituximab for refractory nephrotic syndrome is not clear, depending on the actual severity of the patient’s condition and care and other factors. The basic onset of action is 3-6 months or even longer. Rituximab can trigger B-lymphocyte lysis, thus removing lymphocytes, while reducing nephrotoxicity and tolerability. Its safety and efficacy are generally higher than other classes of drugs. However, there is no complete treatment program for refractory nephrotic syndrome with hormone resistance and it is tricky in clinic, so the time of onset of effect depends on the patient’s condition. Basically, it takes 3-6 months or even longer. For patients with refractory nephrotic syndrome, it is recommended to go to the hospital in time to find out the cause, and then carry out targeted treatment according to the program given by professional doctors.