This novel longitudinal study evaluates the hippocampal metabolic and morphologic effects of different DMTs on the RRMS brain. RRMS patients were on fingolimod(N=36), injectables(N=29) and HCs cohort(N=44). MRS was acquired from hippocampus. Findings revealed that fingolimod is associated with a larger statistically significant reduction in hippocampal Glx (p=0.003) compared to injectable (p=0.01) and trending lower compared to HCs (p=0.09). Hippocampal NAA levels showed statistically significant increase in the fingolimod cohort (p≤0.0001) compared to HCs over the 2-years follow-up. These results demonstrate that fingolimod has a more potent effect on hippocampal Glx and NAA profiles than injectable DMTs.