Introduction. Tuberculosis is one of the oldest infections known to mankind. Of all infectious diseases, tuberculosis causes the most fatalities of any infection. The incidence of tuberculosis on the rise due to the increased prevalence of HIV infection. The incidence of drug resistance strains of mycobacterium is also on the rise. When the mycobacterium is resistant to both INH and rifampicin it is called multi drug resistant tuberculosis. There is a primary and an acquired type of drug resistance. Multidrug resistant tuberculosis is a not only a problem for the patient but also for society at large. The treatment of multidrug resistant tuberculosis requires an entirely different approach. Aim. In this review, we are going to describe the etiopathogenesis, diagnosis, investigations and treatment of multi drug resistant tuberculosis. Material and methods. Analysis of the current literature. Results. Genetic factors, previous treatment, and other factors predisposes the onset of drug resistance. By early detection and prevention of spread of drug resistant strains we can prevent the spread of resistant strains. Conclusion. Drug resistance in tuberculosis is a very complex and dangerous problem. We have to prevent the development and spread of MDRTB. Good quality drugs should be used and made available to all sections of the population. Enhancing the National tuberculosis programs is the best way to attain an effective way to control this menace.