Background:India has the highest burden of TB in the world, accounting for about a quarter of all TB cases worldwide. The Indian government has taken steps to address the problem of drug-resistant TB, including expanding the availability of drug susceptibility testing and increasing access to second-line TB drugs. However, there is still much work to be done to control the spread of drug-resistant TB in India. Improved TB diagnosis and treatment, as well as efforts to prevent the spread of TB in communities, are critical in reducing the prevalence of isoniazid-resistant TB and other forms of drug-resistant TB in India. So, this study aims to assess the risk factors for poor treatment outcomes of H mono Resistant Tuberculosis patients Registered under NTEP, Jamnagar District, Gujarat.Objectives: To assess the risk factors for poor treatment outcome H mono Resistant Tuberculosis patients. To determine the association between poor treatment outcome and various risk factors of H Mono Resistant tuberculosisMethods:It’s a Hospital-based prospective observational Cross-sectional study conducted from February 2020 – August 2021 With a calculated sample size is 100 in Tertiary Care Center .100 patients diagnosed with isoniazid mono resistance tuberculosis and treated with an H mono regimen are enrolled in this study. All patient’s sputum samples were collected and studied initially by smear AFB followed by First line and second-line probe assay. Under treatment, all patients were evaluated clinically and radiologically monthly till and of treatment. Sputum smear microscopy was carried out monthly till the end of treatment. sputum culture for MTB was carried out at the end of 3rd month and the end of treatment (6th month).Conclusion:The male (62%) has more incidence of isoniazid mono-resistant tuberculosis and inferior treatment outcome. underweight (OR=1.432, CI=1.2-1.7), previous TB treatment)(OR=1.667, CI=1.294-2.147), substance addiction(OR-1.457, CI=1.2-1.7), cavity, and/or extensive radio lesion(OR=0.754, CI-0.656-0.866) (OR=13.6, CI-1.7-20) are Associated with H mono regimen failure.Public health Implication: Our findings have important clinical implications for the management of patients with TB. Physicians should consider the presence of cavitary or extensive lesions on chest X-rays and the presence of inhA or katG gene mutations when deciding on the appropriate treatment regimen. Patients with these risk factors may require more intensive treatment approaches, such as longer treatment duration, higher doses of drugs, or the addition of second-line drugs