The iron metabolism plays a key role in the progression of active Tuberculosis. Several studies have shown a link between iron metabolism disorders an active tuberculosis. The aim of this study was to explore the iron metabolism of 100 patients with multidrug-resistant tuberculosis (MDR-TB) treated with second generation anti-tuberculosis drugs. The levels of iron in serum were assessed using atomic absorption spectrometry (AAS) while ferritin and transferrin were determined by imminoturbidimetry methods. The total iron binding capacity and transferrin saturation coefficient were determined from the values of transferrin and iron in the serum. The data showed a significant decrease in values of serum iron and total iron binding capacity (TIBC), in contrast to ferritin and the coefficient of transferrin saturation (CTS) which were in normal range before or after 6 months of treatment. These results are characteristic of inflammatory anemia. The persistence of this anemia despite treatment requires effective management of the inflammatory process in parallel with the use of second line anti-TB drugs.