GeneXpert is a rapid molecular test used to diagnose tuberculosis (TB) and simultaneously detect rifampicin resistance. The rise of Human Immunodeficiency Virus (HIV) has made the way for the re-emergence of Mycobacterium Tuberculosis (MTB) infection, referring to its close link as the “Cursed Duet”. Drug-resistant tuberculosis (DR TB) develops due to incomplete or improper treatment, and today, early diagnosis with simultaneous better understanding of multidrug-resistant (MDR) and extensive drug-resistant (XDR) tuberculosis is needed for the institution of proper treatment and prevention of spread of MDR TB in the community. The main aim and objectives of the study are: 1. To detect Mycobacterium tuberculosis infection in presumptive TB cases using Gene Xpert. 2. To determine the prevalence of Rifampicin-resistant cases in these patients. A retrospective, record-based study was conducted. The smear microscopy and GeneXpert data were collected from the District Tuberculosis Centre from January 2023 to December 2024 and analysed. Out of 3180 presumptive TB samples in our study, 3012 (94.72%) were pulmonary samples, and 168 (5.28%) were extrapulmonary samples. The overall positivity rate of TB for presumptive TB cases was 86.8%, with 4.86% showing rifampicin resistance. Among the 915 presumptive DRTB cases, MTB positivity was in 288 cases (31.47%), with 4 cases (1.38%) showing rifampicin resistance. The GeneXpert MTB/Rif assay is a rapid and highly sensitive test for the early diagnosis of pulmonary and extrapulmonary TB, thereby interrupting the transmission chain, and also for detecting rifampin resistance, thereby preventing treatment failure due to late and improper diagnosis and treatment