diff --git a/browser/src/GenePage/GenePage.tsx b/browser/src/GenePage/GenePage.tsx
index f93a8712b..11151dc64 100644
--- a/browser/src/GenePage/GenePage.tsx
+++ b/browser/src/GenePage/GenePage.tsx
@@ -22,6 +22,7 @@ import {
   isExac,
   hasCopyNumberVariants,
   isV2,
+  isV4,
 } from '@gnomad/dataset-metadata/metadata'
 import ConstraintTable from '../ConstraintTable/ConstraintTable'
 import VariantCooccurrenceCountsTable, {
@@ -134,7 +135,7 @@ export type Gene = GeneMetadata & {
     id: string
   }[]
   exac_regional_missense_constraint_regions?: any
-  gnomad_v2_regional_missense_constraint?: RegionalMissenseConstraint
+  gnomad_regional_missense_constraint?: RegionalMissenseConstraint
   variants: Variant[]
   structural_variants: StructuralVariant[]
   copy_number_variants: CopyNumberVariant[]
@@ -552,9 +553,9 @@ const GenePage = ({ datasetId, gene, geneId }: Props) => {
           />
         )}
 
-        {isV2(datasetId) && (
+        {(isV2(datasetId) || isV4(datasetId)) && (
           <RegionalMissenseConstraintTrack
-            regionalMissenseConstraint={gene.gnomad_v2_regional_missense_constraint}
+            regionalMissenseConstraint={gene.gnomad_regional_missense_constraint}
             gene={gene}
           />
         )}
diff --git a/browser/src/GenePage/GenePageContainer.tsx b/browser/src/GenePage/GenePageContainer.tsx
index 1b0cd7e47..53c0b487e 100644
--- a/browser/src/GenePage/GenePageContainer.tsx
+++ b/browser/src/GenePage/GenePageContainer.tsx
@@ -122,7 +122,7 @@ query ${operationName}($geneId: String, $geneSymbol: String, $referenceGenome: R
       obs_exp
       chisq_diff_null
     }
-    gnomad_v2_regional_missense_constraint {
+    gnomad_regional_missense_constraint {
       passed_qc
       has_no_rmc_evidence
       regions {
diff --git a/browser/src/GenePage/__snapshots__/GenePage.spec.tsx.snap b/browser/src/GenePage/__snapshots__/GenePage.spec.tsx.snap
index 85c86cb51..de1799bee 100644
--- a/browser/src/GenePage/__snapshots__/GenePage.spec.tsx.snap
+++ b/browser/src/GenePage/__snapshots__/GenePage.spec.tsx.snap
@@ -1508,6 +1508,101 @@ exports[`GenePage with CNV dataset "gnomad_cnv_r4" has no unexpected changes 1`]
           </div>
         </div>
       </div>
+      <div
+        className="Track__OuterWrapper-sc-1sdyh2h-0 bBMGlf"
+      >
+        <div
+          className="Track__InnerWrapper-sc-1sdyh2h-1 cEOGGC"
+        >
+          <div
+            className="Track__SidePanel-sc-1sdyh2h-3 iSYzDq"
+            style={
+              {
+                "width": 115,
+              }
+            }
+          >
+            <div
+              className="RegionalMissenseConstraintTrack__SidePanel-sc-1lzrnv-4 clrqtu"
+            >
+              <span>
+                Regional missense constraint
+              </span>
+              <button
+                className="InfoButton__Button-sc-13t5e82-0 gxsoyZ"
+                onClick={[Function]}
+                type="button"
+              >
+                <img
+                  alt=""
+                  aria-hidden="true"
+                  src="test-file-stub"
+                />
+                <span
+                  style={
+                    {
+                      "border": "0",
+                      "clip": "rect(0 0 0 0)",
+                      "height": "1px",
+                      "margin": "-1px",
+                      "overflow": "hidden",
+                      "padding": "0",
+                      "position": "absolute",
+                      "whiteSpace": "nowrap",
+                      "width": "1px",
+                    }
+                  }
+                >
+                  More information
+                </span>
+              </button>
+            </div>
+          </div>
+          <div
+            className="Track__CenterPanel-sc-1sdyh2h-4 iAyrrk"
+            style={
+              {
+                "width": 799,
+              }
+            }
+          >
+            <div
+              className="RegionalMissenseConstraintTrack__PlotWrapper-sc-1lzrnv-1 liGyhW"
+            >
+              <svg
+                height={35}
+                width={799}
+              >
+                <text
+                  dy="1.0rem"
+                  textAnchor="middle"
+                  x={399.5}
+                  y={17.5}
+                >
+                  <tspan>
+                    This gene was not searched for evidence of regional missense constraint. See our
+                     
+                  </tspan>
+                  <tspan
+                    fill="#0000ff"
+                  >
+                    <a
+                      className="Link-sc-14lgydv-0-Link jBvaYQ"
+                      href="/help"
+                      onClick={[Function]}
+                    >
+                      help page
+                    </a>
+                  </tspan>
+                  <tspan>
+                     for additional information.
+                  </tspan>
+                </text>
+              </svg>
+            </div>
+          </div>
+        </div>
+      </div>
       <div
         className="StatusMessage-sc-neg7mh-0 hJFlwG"
       >
@@ -7536,6 +7631,101 @@ exports[`GenePage with SV dataset "gnomad_sv_r4" has no unexpected changes 1`] =
           </div>
         </div>
       </div>
+      <div
+        className="Track__OuterWrapper-sc-1sdyh2h-0 bBMGlf"
+      >
+        <div
+          className="Track__InnerWrapper-sc-1sdyh2h-1 cEOGGC"
+        >
+          <div
+            className="Track__SidePanel-sc-1sdyh2h-3 iSYzDq"
+            style={
+              {
+                "width": 115,
+              }
+            }
+          >
+            <div
+              className="RegionalMissenseConstraintTrack__SidePanel-sc-1lzrnv-4 clrqtu"
+            >
+              <span>
+                Regional missense constraint
+              </span>
+              <button
+                className="InfoButton__Button-sc-13t5e82-0 gxsoyZ"
+                onClick={[Function]}
+                type="button"
+              >
+                <img
+                  alt=""
+                  aria-hidden="true"
+                  src="test-file-stub"
+                />
+                <span
+                  style={
+                    {
+                      "border": "0",
+                      "clip": "rect(0 0 0 0)",
+                      "height": "1px",
+                      "margin": "-1px",
+                      "overflow": "hidden",
+                      "padding": "0",
+                      "position": "absolute",
+                      "whiteSpace": "nowrap",
+                      "width": "1px",
+                    }
+                  }
+                >
+                  More information
+                </span>
+              </button>
+            </div>
+          </div>
+          <div
+            className="Track__CenterPanel-sc-1sdyh2h-4 iAyrrk"
+            style={
+              {
+                "width": 799,
+              }
+            }
+          >
+            <div
+              className="RegionalMissenseConstraintTrack__PlotWrapper-sc-1lzrnv-1 liGyhW"
+            >
+              <svg
+                height={35}
+                width={799}
+              >
+                <text
+                  dy="1.0rem"
+                  textAnchor="middle"
+                  x={399.5}
+                  y={17.5}
+                >
+                  <tspan>
+                    This gene was not searched for evidence of regional missense constraint. See our
+                     
+                  </tspan>
+                  <tspan
+                    fill="#0000ff"
+                  >
+                    <a
+                      className="Link-sc-14lgydv-0-Link jBvaYQ"
+                      href="/help"
+                      onClick={[Function]}
+                    >
+                      help page
+                    </a>
+                  </tspan>
+                  <tspan>
+                     for additional information.
+                  </tspan>
+                </text>
+              </svg>
+            </div>
+          </div>
+        </div>
+      </div>
       <div
         className="StatusMessage-sc-neg7mh-0 hJFlwG"
       >
@@ -10595,6 +10785,101 @@ exports[`GenePage with non-SV dataset "gnomad_cnv_r4" has no unexpected changes
           </div>
         </div>
       </div>
+      <div
+        className="Track__OuterWrapper-sc-1sdyh2h-0 bBMGlf"
+      >
+        <div
+          className="Track__InnerWrapper-sc-1sdyh2h-1 cEOGGC"
+        >
+          <div
+            className="Track__SidePanel-sc-1sdyh2h-3 iSYzDq"
+            style={
+              {
+                "width": 115,
+              }
+            }
+          >
+            <div
+              className="RegionalMissenseConstraintTrack__SidePanel-sc-1lzrnv-4 clrqtu"
+            >
+              <span>
+                Regional missense constraint
+              </span>
+              <button
+                className="InfoButton__Button-sc-13t5e82-0 gxsoyZ"
+                onClick={[Function]}
+                type="button"
+              >
+                <img
+                  alt=""
+                  aria-hidden="true"
+                  src="test-file-stub"
+                />
+                <span
+                  style={
+                    {
+                      "border": "0",
+                      "clip": "rect(0 0 0 0)",
+                      "height": "1px",
+                      "margin": "-1px",
+                      "overflow": "hidden",
+                      "padding": "0",
+                      "position": "absolute",
+                      "whiteSpace": "nowrap",
+                      "width": "1px",
+                    }
+                  }
+                >
+                  More information
+                </span>
+              </button>
+            </div>
+          </div>
+          <div
+            className="Track__CenterPanel-sc-1sdyh2h-4 iAyrrk"
+            style={
+              {
+                "width": 799,
+              }
+            }
+          >
+            <div
+              className="RegionalMissenseConstraintTrack__PlotWrapper-sc-1lzrnv-1 liGyhW"
+            >
+              <svg
+                height={35}
+                width={799}
+              >
+                <text
+                  dy="1.0rem"
+                  textAnchor="middle"
+                  x={399.5}
+                  y={17.5}
+                >
+                  <tspan>
+                    This gene was not searched for evidence of regional missense constraint. See our
+                     
+                  </tspan>
+                  <tspan
+                    fill="#0000ff"
+                  >
+                    <a
+                      className="Link-sc-14lgydv-0-Link jBvaYQ"
+                      href="/help"
+                      onClick={[Function]}
+                    >
+                      help page
+                    </a>
+                  </tspan>
+                  <tspan>
+                     for additional information.
+                  </tspan>
+                </text>
+              </svg>
+            </div>
+          </div>
+        </div>
+      </div>
       <div
         className="StatusMessage-sc-neg7mh-0 hJFlwG"
       >
@@ -29545,6 +29830,101 @@ exports[`GenePage with non-SV dataset "gnomad_r4" has no unexpected changes 1`]
           </div>
         </div>
       </div>
+      <div
+        className="Track__OuterWrapper-sc-1sdyh2h-0 bBMGlf"
+      >
+        <div
+          className="Track__InnerWrapper-sc-1sdyh2h-1 cEOGGC"
+        >
+          <div
+            className="Track__SidePanel-sc-1sdyh2h-3 iSYzDq"
+            style={
+              {
+                "width": 115,
+              }
+            }
+          >
+            <div
+              className="RegionalMissenseConstraintTrack__SidePanel-sc-1lzrnv-4 clrqtu"
+            >
+              <span>
+                Regional missense constraint
+              </span>
+              <button
+                className="InfoButton__Button-sc-13t5e82-0 gxsoyZ"
+                onClick={[Function]}
+                type="button"
+              >
+                <img
+                  alt=""
+                  aria-hidden="true"
+                  src="test-file-stub"
+                />
+                <span
+                  style={
+                    {
+                      "border": "0",
+                      "clip": "rect(0 0 0 0)",
+                      "height": "1px",
+                      "margin": "-1px",
+                      "overflow": "hidden",
+                      "padding": "0",
+                      "position": "absolute",
+                      "whiteSpace": "nowrap",
+                      "width": "1px",
+                    }
+                  }
+                >
+                  More information
+                </span>
+              </button>
+            </div>
+          </div>
+          <div
+            className="Track__CenterPanel-sc-1sdyh2h-4 iAyrrk"
+            style={
+              {
+                "width": 799,
+              }
+            }
+          >
+            <div
+              className="RegionalMissenseConstraintTrack__PlotWrapper-sc-1lzrnv-1 liGyhW"
+            >
+              <svg
+                height={35}
+                width={799}
+              >
+                <text
+                  dy="1.0rem"
+                  textAnchor="middle"
+                  x={399.5}
+                  y={17.5}
+                >
+                  <tspan>
+                    This gene was not searched for evidence of regional missense constraint. See our
+                     
+                  </tspan>
+                  <tspan
+                    fill="#0000ff"
+                  >
+                    <a
+                      className="Link-sc-14lgydv-0-Link jBvaYQ"
+                      href="/help"
+                      onClick={[Function]}
+                    >
+                      help page
+                    </a>
+                  </tspan>
+                  <tspan>
+                     for additional information.
+                  </tspan>
+                </text>
+              </svg>
+            </div>
+          </div>
+        </div>
+      </div>
       <div
         className="TrackPage__TrackPageSection-sc-1xq3qi7-1 fQVUsz"
       >
@@ -31086,6 +31466,101 @@ exports[`GenePage with non-SV dataset "gnomad_r4_non_ukb" has no unexpected chan
           </div>
         </div>
       </div>
+      <div
+        className="Track__OuterWrapper-sc-1sdyh2h-0 bBMGlf"
+      >
+        <div
+          className="Track__InnerWrapper-sc-1sdyh2h-1 cEOGGC"
+        >
+          <div
+            className="Track__SidePanel-sc-1sdyh2h-3 iSYzDq"
+            style={
+              {
+                "width": 115,
+              }
+            }
+          >
+            <div
+              className="RegionalMissenseConstraintTrack__SidePanel-sc-1lzrnv-4 clrqtu"
+            >
+              <span>
+                Regional missense constraint
+              </span>
+              <button
+                className="InfoButton__Button-sc-13t5e82-0 gxsoyZ"
+                onClick={[Function]}
+                type="button"
+              >
+                <img
+                  alt=""
+                  aria-hidden="true"
+                  src="test-file-stub"
+                />
+                <span
+                  style={
+                    {
+                      "border": "0",
+                      "clip": "rect(0 0 0 0)",
+                      "height": "1px",
+                      "margin": "-1px",
+                      "overflow": "hidden",
+                      "padding": "0",
+                      "position": "absolute",
+                      "whiteSpace": "nowrap",
+                      "width": "1px",
+                    }
+                  }
+                >
+                  More information
+                </span>
+              </button>
+            </div>
+          </div>
+          <div
+            className="Track__CenterPanel-sc-1sdyh2h-4 iAyrrk"
+            style={
+              {
+                "width": 799,
+              }
+            }
+          >
+            <div
+              className="RegionalMissenseConstraintTrack__PlotWrapper-sc-1lzrnv-1 liGyhW"
+            >
+              <svg
+                height={35}
+                width={799}
+              >
+                <text
+                  dy="1.0rem"
+                  textAnchor="middle"
+                  x={399.5}
+                  y={17.5}
+                >
+                  <tspan>
+                    This gene was not searched for evidence of regional missense constraint. See our
+                     
+                  </tspan>
+                  <tspan
+                    fill="#0000ff"
+                  >
+                    <a
+                      className="Link-sc-14lgydv-0-Link jBvaYQ"
+                      href="/help"
+                      onClick={[Function]}
+                    >
+                      help page
+                    </a>
+                  </tspan>
+                  <tspan>
+                     for additional information.
+                  </tspan>
+                </text>
+              </svg>
+            </div>
+          </div>
+        </div>
+      </div>
       <div
         className="TrackPage__TrackPageSection-sc-1xq3qi7-1 fQVUsz"
       >
diff --git a/data-pipeline/src/data_pipeline/datasets/gnomad_v2/gnomad_v2_regional_missense_constraint.py b/data-pipeline/src/data_pipeline/datasets/gnomad_v2/gnomad_v2_regional_missense_constraint.py
index 73621b5f0..da0d8da65 100644
--- a/data-pipeline/src/data_pipeline/datasets/gnomad_v2/gnomad_v2_regional_missense_constraint.py
+++ b/data-pipeline/src/data_pipeline/datasets/gnomad_v2/gnomad_v2_regional_missense_constraint.py
@@ -1,7 +1,7 @@
 import hail as hl
 
 
-def prepare_gnomad_v2_regional_missense_constraint(path):
+def prepare_gnomad_regional_missense_constraint(path):
     ds = hl.read_table(path)
 
     # rename key field transcript_id to transcript to allow merging in genes pipeline
diff --git a/data-pipeline/src/data_pipeline/pipelines/genes.py b/data-pipeline/src/data_pipeline/pipelines/genes.py
index 7b7ab14eb..be340c7ae 100644
--- a/data-pipeline/src/data_pipeline/pipelines/genes.py
+++ b/data-pipeline/src/data_pipeline/pipelines/genes.py
@@ -24,7 +24,7 @@
 from data_pipeline.datasets.exac.exac_regional_missense_constraint import prepare_exac_regional_missense_constraint
 from data_pipeline.datasets.gnomad_v2.gnomad_v2_constraint import prepare_gnomad_v2_constraint
 from data_pipeline.datasets.gnomad_v2.gnomad_v2_regional_missense_constraint import (
-    prepare_gnomad_v2_regional_missense_constraint,
+    prepare_gnomad_regional_missense_constraint,
 )
 
 from data_pipeline.pipelines.variant_cooccurrence_counts import (
@@ -256,6 +256,9 @@
     {
         "gtex_struct_path": pipeline.get_task("prepare_gtex_v10_expression_data"),
     },
+    {
+        "exclude_v10_tissues": True,
+    },
 )
 
 pipeline.add_task(
@@ -315,9 +318,20 @@
 
 pipeline.add_task(
     "prepare_gnomad_v2_regional_missense_constraint",
-    prepare_gnomad_v2_regional_missense_constraint,
+    prepare_gnomad_regional_missense_constraint,
     f"/{constraint_subdir}/gnomad_v2_regional_missense_constraint.ht",
-    {"path": "gs://gcp-public-data--gnomad/release/2.1.1/regional_missense_constraint/gnomad_v2.1.1_rmc.ht"},
+    {
+        "path": "gs://gcp-public-data--gnomad/release/2.1.1/regional_missense_constraint/gnomad_v2.1.1_rmc.ht",
+    },
+)
+
+pipeline.add_task(
+    "prepare_gnomad_v4_regional_missense_constraint",
+    prepare_gnomad_regional_missense_constraint,
+    f"/{constraint_subdir}/gnomad_v4_regional_missense_constraint.ht",
+    {
+        "path": "gs://gnomad-v4-data-pipeline/inputs/regional_missense_constraint/rmc_browser.ht",
+    },
 )
 
 ###############################################
@@ -377,7 +391,7 @@ def annotate_with_preferred_transcript(table_path):
         "exac_constraint": pipeline.get_task("prepare_exac_constraint"),
         "exac_regional_missense_constraint": pipeline.get_task("prepare_exac_regional_missense_constraint"),
         "gnomad_constraint": pipeline.get_task("prepare_gnomad_v2_constraint"),
-        "gnomad_v2_regional_missense_constraint": pipeline.get_task("prepare_gnomad_v2_regional_missense_constraint"),
+        "gnomad_regional_missense_constraint": pipeline.get_task("prepare_gnomad_v2_regional_missense_constraint"),
     },
     {"join_on": "preferred_transcript_id"},
 )
@@ -469,19 +483,30 @@ def annotate_with_constraint(genes_path, constraint_path):
 
 pipeline.add_task(
     "annotate_grch38_genes_step_6",
-    reject_par_y_genes,
+    annotate_table,
     f"/{genes_subdir}/genes_grch38_annotated_6.ht",
     {
-        "genes_path": pipeline.get_task("annotate_grch38_genes_step_5"),
+        "table_path": pipeline.get_task("annotate_grch38_genes_step_5"),
+        "gnomad_regional_missense_constraint": pipeline.get_task("prepare_gnomad_v4_regional_missense_constraint"),
+    },
+    {"join_on": "preferred_transcript_id"},
+)
+
+pipeline.add_task(
+    "annotate_grch38_genes_step_7",
+    reject_par_y_genes,
+    f"/{genes_subdir}/genes_grch38_annotated_7.ht",
+    {
+        "genes_path": pipeline.get_task("annotate_grch38_genes_step_6"),
     },
 )
 
 pipeline.add_task(
     "remove_grch38_genes_constraint_for_release",
     remove_gnomad_v4_constraint,
-    f"/{genes_subdir}/genes_grch38_annotate_5_removed_constraint",
+    f"/{genes_subdir}/genes_grch38_annotate_7_removed_constraint",
     {
-        "genes_path": pipeline.get_task("annotate_grch38_genes_step_5"),
+        "genes_path": pipeline.get_task("annotate_grch38_genes_step_7"),
     },
 )
 
@@ -548,7 +573,7 @@ def annotate_with_constraint(genes_path, constraint_path):
 pipeline.set_outputs(
     {
         "genes_grch37": "annotate_grch37_genes_step_5",
-        "genes_grch38": "annotate_grch38_genes_step_6",
+        "genes_grch38": "annotate_grch38_genes_step_7",
         "base_transcripts_grch37": "extract_grch37_transcripts",
         "base_transcripts_grch38": "extract_grch38_transcripts",
         "transcripts_grch37": "annotate_grch37_transcripts",
diff --git a/graphql-api/src/graphql/types/gene.graphql b/graphql-api/src/graphql/types/gene.graphql
index e41c6bda5..5eeb68f52 100644
--- a/graphql-api/src/graphql/types/gene.graphql
+++ b/graphql-api/src/graphql/types/gene.graphql
@@ -64,7 +64,8 @@ type Gene {
   pext: Pext
 
   gnomad_constraint: GnomadConstraint
-  gnomad_v2_regional_missense_constraint: GnomadV2RegionalMissenseConstraint
+  # gnomad_v2_regional_missense_constraint: GnomadV2RegionalMissenseConstraint
+  gnomad_regional_missense_constraint: GnomadV2RegionalMissenseConstraint
 
   exac_constraint: ExacConstraint
   exac_regional_missense_constraint_regions: [ExacRegionalMissenseConstraintRegion!]
diff --git a/graphql-api/src/queries/gene-queries.ts b/graphql-api/src/queries/gene-queries.ts
index 530e8eb76..95a4aef0d 100644
--- a/graphql-api/src/queries/gene-queries.ts
+++ b/graphql-api/src/queries/gene-queries.ts
@@ -1,12 +1,14 @@
-import { withCache } from '../cache'
+// import { withCache } from '../cache'
 
 import { fetchAllSearchResults } from './helpers/elasticsearch-helpers'
 
 const GENE_INDICES = {
   // GRCh37: 'genes_grch37',
   // GRCh38: 'genes_grch38',
-  GRCh37: 'genes_grch37-2024-11-15--15-23',
-  GRCh38: 'genes_grch38-2024-11-20--16-28',
+  // GRCh37: 'genes_grch37-2024-11-15--15-23',
+  // GRCh38: 'genes_grch38-2024-11-20--16-28',
+  GRCh37: 'genes_grch37-2024-11-25--15-55',
+  GRCh38: 'genes_grch38-2024-11-25--19-00',
 }
 
 const _fetchGeneById = async (esClient: any, geneId: any, referenceGenome: any) => {
@@ -29,11 +31,12 @@ const _fetchGeneById = async (esClient: any, geneId: any, referenceGenome: any)
   }
 }
 
-export const fetchGeneById = withCache(
-  _fetchGeneById,
-  (_: any, geneId: any, referenceGenome: any) => `gene:${geneId}:${referenceGenome}`,
-  { expiration: 86400 }
-)
+// export const fetchGeneById = withCache(
+//   _fetchGeneById,
+//   (_: any, geneId: any, referenceGenome: any) => `gene:${geneId}:${referenceGenome}`,
+//   { expiration: 86400 }
+// )
+export const fetchGeneById = _fetchGeneById
 
 export const fetchGeneBySymbol = async (esClient: any, geneSymbol: any, referenceGenome: any) => {
   const response = await esClient.search({