The prevalence of multi-drug resistance (MDR) in separate territories of the Irkutsk region is different, which is as-sociated with the geographical features and the availability of microbiological research facilities. Between 2003 and 2015, the proportion of new TB cases with MDR increased in most of the territories of the region except “Large Cities” and the Buryat national district. In Large Cities of Irkutsk region and Buryat district MDR level is high, but the growth rate is insignificant. The area of “Major settlements along the railway” was characterized by an intensive increase in the proportion of first-time detected and previously treated TB patients with MDR. One reason for this phenomenon is the intense migration of the population. In “Northern areas” there was an accumulation of MDR among contingents associated with the empirical assignment of anti-TB drugs and low availability of microbiological testing. In the “Rural areas” MDR was rarely identified due to troubles with microbiological diagnostics.