Treatment of rifampin-resistant and multidrug-resistant tuberculosis in pregnant women is more complicated since little is known about the safety of second-line antituberculosis drugs during pregnancy and lactation. Drug-resistant tuberculosis, not having many options in the past, has been treated with regimens that include drugs with teratogenic potentials, such as thioamides and second-line injectables. Currently, there are new oral drugs, including bedaquiline, for the treatment of drugresistant disease; however, the safety of bedaquiline during pregnancy and lactation has not been satisfactorily demonstrated so far. We report the first case in Mexico treated with a regimen that includes bedaquiline for multidrug-resistant tuberculosis during pregnancy, with favorable results, and without maternal-fetal complications.