Tuberculosis is an emergent burden for the public health, with costly treatment. When inadequate treatment and poor adherence are associated with primary TB, tubercle bacilli resistant to first line drugs arise. The combined resistance to both Isoniazid and Rifampicin, here termed multi-drug resistant tuberculosis (MDR-TB). MDR-TB is emerging since 1990s and constitute one of the major challenges to TB eradication, in addition to HIV pandemic. A retrospective study to evaluate the clinical management of MDR-TB and features has been conducted on 154 patients admitted in Kabutare Hospital, Rwanda the period of 2009-2010. The results of these investigations can be found in this book.