Abstract: Objective To understand the status of acquired drug-resistant tuberculosis (ADR-TB) and explore main risk factors of ADR-TB, and to provide evidence for the development of prevention and control measures of ADR-TB.Methods The data of 445 adult patients of pulmonary tuberculosis (PTB) (sputum culture positive for Mycobacterium tuberculosis), including 224 cases of drug-resistant TB (the DR group) and 221 cases of non-drug resistant TB (the control group), who sought for medical care in an infectious diseases hospital affiliated to Guangxi from 1 January, 2004 to 30 December, 2007 were collected. Multivariate unconditioned logistic regression analysis was used to analyze the risk factors.Results The rate of mono-resistant TB was 38.84% (87/224), and that of multi-drug resistant tuberculosis (MDR-TB) was 39.29%(88/224), the first three rates of drug resistance were isoniazid 73.21% (164/224), rifampin 56.70% (127/224) and streptomycin 50.89% (114/224). The result of multivariate unconditioned logistic regression analysis showed that risk factors for drug resistance included treatment interruption (OR=39.641, 95%CI=20.366-51.369, P=0.000), retreatment (OR=35.874, 95%CI=21.569-55.786, P=0.000), combined with diabetes (OR=8.964, 95%CI＝5.365-18.971, P=0.009), long course of disease(OR=6.001, 95%CI=3.047-8.635,P=0.012), non-TB control institute as the first institute of treatment (OR=5.003, 95%CI＝3.089-8.114, P=0.007), male (OR=0.321, 95%CI=0.378-0.826, P=0.013), migrant population (OR=2.968, 95%CI=1.677-4.486, P=0.041), living in countryside (OR=2.746, 95%CI=1.024-6.243, P=0.047), low educational level (OR=0.389, 95%CI=0.225-0.978, P=0.000), elder (OR=0.439, 95%CI=0.277-0.834, P=0.000) and smoking (OR=1.758, 95%CI=1.067-3.374,P=0.049).Conclusion We should attach great significance to the aforementioned risk factors of ADR-TB and carry out effective intervention measures to reduce the incidence rate of ADR-TB in the future.