Abstract: Multidrug resistant tuberculosis (MDR-TB) is a man-made problem. While, tuberculosis is hundred percent curable, MDR-TB is difficult to treat. Inadequate and incomplete treatment and poor treatment adherence has led to this type of drug resistance. Emergence of MDR-TB is reported worldwide. Better management and control of tuberculosis specially drug resistant TB by experienced and qualified doctors, access to standard microbiology laboratory, co-morbidity of HIV and tuberculosis, new anti-TB drug regimens, better diagnostic tests, international standards for second line drugs (SLD) susceptibility testing, invention of newer antitubercular molecules and vaccines and knowing the real magnitude of MDR-TB are some of the important issues to be addressed for effective prevention and management of MDR-TB.