To learn and understand the epidemiology, diagnostic issue and management of MDR tuberculosis. Drug resistant tuberculosis has been reported since the early days of introduction of antitubercular chemotherapy, but recently multidrug resistant tuberculosis (MDR TB), has been an area of growing concern, and is posing threat to globule efforts of tuberculosis control. Non compliant patients due to monetary lack, lack of information, side effect of drugs and social myths and misconceptions often do not adhere to treatment. Co-morbid conditions like diabetes, HIV, Psychiatric conditions, the habit of smoking and alcoholism make the patients more vulnerable. Do not accept sensitivity report uncritically but always correlate with clinical, chest radiograph and smear result. Elucidated with clinical case reports.