Introduction: Magnetic resonance imaging (MRI) has diverse modalities, among which gadolinium-enhanced DTPA (GdDTPA) visualizes acute lesions referred to as contrast-enhancing lesions (CELs) in multiple sclerosis (MS). In this regard, the current study aims to assess the neuroimaging characteristics of MS-related CELs in a 12-month follow-up study. Material and Methods: This prospective cohort study was conducted on 41 patients with relapsing-remitting MS (RRMS) in 2019-21. The participants' demographic characteristics and Expanding Disability Status Scale (EDSS) were recorded. GdDTPA MRI was performed once, repeated within the next year, and interpreted by a panel of an expert neurologist and two skilled neuroradiologists. Results: The MR assessments of the patients revealed 139 active plaques, among which 52 (37.5%), 49 (35.2%), and 38 (27.3%) had nodular, heterogeneous, and ring & arch pattern of enhancement, respectively. Eighteen plaques remained activated within the next year with heterogenous (11.2%), ring & arch (44.4%), and nodular (44.4%) enhancement patterns. The inactivated ones turned into gliosis (84.6%) and black hole (15.4%). EDSS was statistically less in nodular plaques than both ring & arch (P-value = 0.009) and heterogeneous patterns (P-value = 0.028). Conclusion: The current study found that most of the plaques get inactivated during one year and changes to gliosis. Patients with a predominant nodular enhancement pattern had a lower increase in EDSS during one year follow up, in contrast who had the predominant ring & arch pattern experienced the highest. Additionally, the nodular pattern causes fewer disabilities in comparison to other types based on EDSS.