ABSTRACTIntroductionPatient Acceptable Symptom State (PASS) is emerging as a valuable subjective measure of the overall myasthenia gravis (MG)‐related burden. This study aimed at identifying PASS‐positive thresholds for the most used clinical scales, investigating whether PASS and MGFA post‐intervention status capture different aspects of the disease outcome, and identifying clinical variables associated with PASS=YES response.MethodsAdult AChR‐MG patients were prospectively enrolled at two Italian Centres (Rome: index cohort; Florence: validation cohort). PASS thresholds for MG‐ADL, QMG, and MG‐QOL15r were defined in the index cohort by ROC analysis and validated in the validation cohort; predictors of favorable PASS were identified by multivariable analysis.ResultsThis study included 173 patients (44% females, median age at onset: 53 years). PASS=YES patients had significantly lower median MG‐ADL, QMG, and MG‐QOL15r scores, with the following thresholds for PASS=YES: MG ADL ≤ 2, QMG ≤ 8 and MG‐QOL15r ≤ 6. The MG‐ADL (OR = 0.46, 95% CI = 0.36–0.60, p < 0.001), QMG (OR = 0.72, 95% CI = 0.64–0.81, p < 0.001) and MG‐QOL15r (OR = 0.76, 95% CI = 0.70–0.84, p < 0.001), were independently associated with a favorable PASS. The degree of ocular involvement in each scale was the strongest negative determinant of PASS=YES.ConclusionsThis study validates the PASS question and highlights the relevance of ocular complaints in patients' perception of MG burden.