To assess the effectiveness of fumarates (FUM) in Black, Hispanic, Asian, and White people with multiple sclerosis (pwMS). Racial/ethnic minority patient populations are generally underrepresented in clinical trials. Dimethyl fumarate (DMF) and diroximel fumarate (DRF) are disease-modifying therapies for relapsing MS. Data describing FUM effectiveness in racial/ethnic pwMS are limited. This retrospective analysis of the Komodo Health Claims Database included patients 18-64 years old with ≥1 claim for MS diagnosis and a claim for DMF or DRF between 01-Jan-2017 to 31-May-2022. Index date was the first FUM claim date. Patients were followed from index to first occurrence of end of study, end of insurance eligibility, gap >45 days, or DMT switch. This analysis included 1241 Black, 777 Hispanic, 132 Asian, and 4650 White pwMS treated with FUM. Baseline mean (SD) MS severity scores were: Black, 7.1 (4.2); Hispanic, 6.4 (4.0); Asian, 6.0 (3.3); and White, 6.4 (4.1). Baseline (1 year pre-index) annualized relapse rate (ARR) (95% CI) was 0.338 (0.297-0.385) in Black patients, compared with 0.311 (0.258-0.376), 0.295 (0.212-0.412), and 0.299 (0.273-0.326) in Hispanic, Asian, and White patients, respectively. Mean FUM exposure post-index ranged from 449-559 days. Post-index, ARR (95% CI) reduced to 0.252 (0.212-0.300) in Black patients, compared with 0.185 (0.138-0.248), 0.163 (0.104-0.256), and 0.214 (0.182-0.251) in Hispanic, Asian, and White patients, respectively. Estimated proportions relapse-free (95% CI) at 24 months were: Black, 77.0% (73.7%-80.3%); Hispanic, 75.4% (71.0%-80.0%), Asian, 81.7% (73.0%-90.3%); and White, 80.5% (70.0%-82.1%). Absolute lymphocyte count reductions (95% CI) after 12 months on FUM were 10.3% (3.8%-16.3%), 20.1% (14.8%-25.1%), 14.4% (0.6%-26.3%) and 20.4% (18.0%-22.7%) in Black, Hispanic, Asian, and White patients, respectively. Similar FUM efficacy was observed in all racial/ethnic subgroups in this analysis of 2150 racial/ethnic minority pwMS, consistent with prior studies. Disclosure: Sophia Woodson has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MSSA. Sophia Woodson has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Sophia Woodson has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Sophia Woodson has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Genentech. Sophia Woodson has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb . Dr. Gettings has nothing to disclose. Dr. Guo has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Klineova has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Klineova has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Klineova has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Ms. Lee has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Ms. Lee has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Bristol meyers Squibb . Ms. Lee has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Alexion. Ms. Lee has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Horizon. Dr. Romero has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Romero has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics . Dr. Romero has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Romero has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon. Dr. Fong has received personal compensation for serving as an employee of Biogen. Dr. Belviso has received personal compensation for serving as an employee of Biogen. Mr. Bian has received personal compensation for serving as an employee of Biogen. Dr. Lewin has received personal compensation for serving as an employee of Biogen. Dr. Lewin has stock in Biogen. Dr. Shankar has received personal compensation for serving as an employee of Biogen. Dr. Shankar has stock in Biogen.