The study compared the efficacy of low (100 mg per dose, n=31), medium (500 mg per dose, n=32) and standard (375 mg/m² per dose, n=37) doses of rituximab in 100 patients with membranous nephropathy in hospitals in Xuzhou from May 2021 to December 2024. All three doses significantly reduced urinary protein levels (24-hour total protein). and anti-PLA2R antibody titers versus baseline (p < 0.05). Serum albumin increased significantly in all groups (p < 0.05), while serum creatinine and glomerular filtration did not change (p > 0.05). The overall remission rate after 12 months was 67.74% in the low-dose group, 65.63% in the medium-dose group, and 64.84% in the standard group without a statistically significant difference (p > 0.05). The incidence of adverse reactions was comparable between groups (p > 0.05). The three dosage regimens had comparable therapeutic efficacy without affecting renal function.