Systems and methods for Multiple-Input and Multiple-Output (MIMO) rank reduction to improve downlink throughput are disclosed. A method of operation of a radio access node includes determining that an imbalance between parallel channels of a spatial multiplexing downlink transmission to a wireless device is greater than an imbalance threshold and/or that a Negative Acknowledgement (NACK) rate over time for the parallel channels of a spatial multiplexing downlink transmission reported by the wireless device is greater than a NACK rate threshold. The method also includes, in response to determining that the imbalance between the parallel channels is greater than the imbalance threshold and/or that the NACK rate is greater than the NACK rate threshold, performing a fast rank reduction for a next downlink transmission whereby a rank is reduced from a rank indicator reported by the wireless device to some lower rank. Reducing the rank may improve downlink throughput.