Background: Drug resistant M.tuberculosis is one of the serious public health trouble that intimidating progress made in tuberculosis cases and control in several countries. Early detection of drug-resistant tuberculosis is crucial for patient management and infection control. Methods: Hospital based cross-sectional study design was conducted from October 2020 to February 2021. Detection of Mycobacterium tuberculosis and resistance to Rifampicin pattern was determined by using GeneXpert MTB/RIF assay. Data were entered and analyzed by SPSS version 23.0. Bivariate and multivariate analyses were used to examine the relationship between dependent and independent variables. Less than 0.05 P-value was used to show significance.Results: A total of 301 presumptive tuberculosis patients were included in the study; of these, 46 (15.3%) of them were identified as having Mycobacterium tuberculosis, 2/46 (4.35%) were resistant to Rifampicin and 4/46 (14.8%) patients were TB/HIV co-infected. From the total of M. tuberculosis detected 40 (16.7%) were identified in pulmonary and 6 (9.8%) were in extra-pulmonary presumptive patients. Rifampicin-resistant M. tuberculosis was detected in 2 patients who had a history of taking Anti-tuberculosis drugs. Conclusion: Previous history of tuberculosis treatment and having close contact history with tuberculosis patients were found as important associated factors that enhance the prevalence of tuberculosis among presumptive tuberculosis patients. This indicates the mandate to make better and oversee the treatment protocol to control the burden of drug resistant M.tuberculosis.