Rational targets for autoimmune neuromuscular disease have been identified with the progress of our understanding of the cellular and molecular process underlying autoimmune neuromuscular disease. Although antigen-specific immunotherapy is not available, effective immunotherapy for most autoimmune disorders is provided with old and new immunomodulatory treatments, alone or in combination. The achievements of more specific yet largely experimental therapeutic tools need to be tested in the human diseases. Here we review the principles and targets of immunotherapy for autoimmune neuromuscular disorders, applications, and practical guidelines, and give an outlook on future developments.