Idiopathic refractory membranous nephropathy (IRMN) is a form of nephrotic syndrome with a high risk of progression to end-stage renal disease, where treatment options are limited. Obinutuzumab, a humanized anti-CD20 antibody, destroys CD20+ cells and leads to improved immunity and decreased urinary protein in patients with IRMN. The study followed 31 patients with IRMN after treatment with obinutuzumab for 12 months. After one year, the overall remission rate was 80%, with 16% complete remission and 64% partial remission, with a median time to remission of 4.5 months. Immunological remission was at the level of 70%, 83%, 90% and 93% after 3, 6, 9 and 12 months. 80% of patients had a rapid decrease in anti-PLA2R antibodies in the first 3 months (p < 0.001), 64% had a reduction of more than 50%, and all patients were negative at the end. Adverse events included infusion reactions such as fever, hypotension, tachycardia, and flushing, with no deaths. Obinutuzumab is effective in inducing remission with a good safety profile.