Abstract: Objective To explore adverse drug reactions (ADR) of chemotherapy and treatment in patients with multidrug resistant tuberculosis (MDR-TB).Methods We analyzed retrospectively 96 patients enrolled MDR-TB project of Global fund and completed treatment in Guangzhou chest hospital from November 2008 to July 2013. The chemotherapy regimen was 6 Km(Am)-Z-Lfx(Ofx)-PAS(Cs)-Pto/18Z-Lfx(Ofx)-PAS(Cs)-Pto. The data including general condition, regimen, ADR and treatment were analyzed.Results There were 83 cases (86.5%,83/96) suffered from ADR in 96 patients who completed the course of treatment. The occurrence rate of ADR for the cases of cure and failure were 87.1% (54/62) and 85.3% (29/34) without statistical significance (χ²=0.06, P=0.806), respectively. In 0-1st month, 2nd-6th month of treatment, the incidences of ADR were 40.7% (22/54) and 46.3% (25/54) among patients who cured; 34.5% (10/29) and 55.2% (16/29) among patients who were failure, respectively. There was no statistical difference (χ²=0.31, P=0.577 and χ²=0.60,P=0.441).The common ADRs were nausea/vomiting (50.0%, 48/96), arthralgia (25.0%, 23/96), dizziness and headache (13.5%,13/96), and hepatitis (15.6%,15/96). The ADRs caused by Cfz,Pto,PAS,Clr,Lfx,Km,Z were common, and the incidence of these drugs were 100% (7/7), 48.7% (39/80),48.4% (31/64),47.1% (8/17), 28.5% (20/70), 28.3% (17/60), and 26.2% (22/84). 107 cases (69.5%) needed to stop relative drugs and then replaced with other drugs.Conclusion The occurrence rate of ADR of the chemotherapy for MDR-TB are relatively higher and vary. It needs to adopt correct strategy and standardized treatment.