The prevalence of multi-drug resistant tuberculosis is increasing globally which has upset tuberculosis treatment and control programmes. The problem has been further complicated by co-infection with HIV virus. Treatment of multi drug resistant tuberculosis is difficult, expensive and requires long duration chemotherapy. The long term prognosis is poor with frequent relapses following cessation of treatment. Health care workers are at considerable risk of contacting the disease. New, potent and less toxic drugs are required for management of multi drug resistant strains. Directly observed therapy of tuberculosis seems to be promising but demands enormous resources. Finally strengthening of tuberculosis control programmes for prevention and control of tuberculosis is essential.