This document discusses multi-drug resistant tuberculosis (MDR-TB). It provides global statistics on TB incidence and mortality. MDR-TB is defined as disease resistant to at least two first-line anti-TB drugs. Countries with significant MDR-TB burdens are listed. The Indian scenario outlines that India has a high TB burden and accounts for 20% of global cases. A case study from Andhra Pradesh examines 75 MDR-TB patients. Clinical factors promoting drug resistance and mechanisms of resistance are reviewed. Treatment of MDR-TB and new chemotherapeutic agents are discussed. Global targets for TB control by 2015 are presented.