|Anime||Naruto Shippūden Episode #285|
|Appears in||Anime only|
While having a quiet, reserved demeanour, Ruka is fiercely loyal to her village and equally so to her comrades as she spoke out against Pakura's tirade against Kirigakure telling her that the Fifth Mizukage would usher in a new era for the village while worrying about the safety of her comrades.
Ruka is quite capable at using Water Release techniques, as she was able to counter Pakura's Scorch Release using a mixture of the Water Release: Water Formation Wall technique and a stream of water. She can also readily change the amount of water she employs in her techniques.
As a medical-nin, Ruka has basic knowledge of medical treatments and ninjutsu, as well as good chakra control.
Fourth Shinobi World War: Confrontation
As the reincarnated shinobi reappeared on the battlefield, most of the Third Division is scattered into small squads. Ruka is part of a squad led by Monga. Ruka promised Monga that she would also put her life on the line to save his, if something were to happen to him. Gari appears before the squad and after a short fight, is blown up by Monga. Ruka and the squad look in shock when Monga is mummified by Pakura. Maki explains to Ruka that she was once the kunoichi's student. After revealing her death at the hands of Kirigakure, Ruka explains to Pakura that the "Bloody Mist" was no longer the murderous village it used to be thanks to the Fifth Mizukage, however Pakura notes that it would not erase the past. Pakura launched another attack on the squad and incinerates the area to find the hiding shinobi. The squad protect themselves from the blast with Maki's Cloth Binding Technique and Ruka's Water Release. Pakura finds the squad and prepares to kill them until the arrival of Omoi and Zaji. As Gari's regeneration is finished, he joins Pakura in fighting the shinobi but having a change of heart, Pakura allows the squad to flee while halting Gari's movements.