Background: In India, tuberculosis (TB) is a leading cause of morbidity and mortality. One-fifth of the cases of tuberculosis worldwide occur in India. The present study was conducted to assess pattern of drug-resistance in multidrug-resistant pulmonary tuberculosis. Materials &Methods: 120 patients of multidrug-resistant pulmonary tuberculosis of both genders were selected. Sputum specimens were collected in sterile wide mouthed bottles from sputum smear-positive patients of pulmonary TB. Sputum culture and drug sensitivity tests (DST) were carried out. Results: Out of 120 patients, 78 were males and 42 were females. Resistance pattern against HR was seen in 23, HRE in 15, HRS in 32 and HRSE in 50 patients. The difference was significant (P< 0.05).17 HR, 11 HRE, 24 HRs and 40 HRSE cured. 1 HR, 1 HRE, 2 HRS and 2 HRSE died. Conclusion: The commonest pattern observed in this study was resistance to all four first-line drugs followed by resistance to isoniazid plus rifampicin plus streptomycin.