Objective:To determine the prevalence and risk factors associated with drug resistant tuberculosis(TB) in South West Nigeria.Methods:A retrospective study conducted among pulmonary tuberculosis(PTB) patients from Oyo and Osun States in South West Nigeria who had their culture and drug susceptibility test performed at the institute of tropical medicine Antwerp, Belgium between 2007 and 2009.Data on the patient’s characteristics were retrieved from the TB treatment card.Univariate analysis was performed to assess the risk factors for drug resistant tuberculosis.The Level of significance was at P<0.05.Results:Among the 88 patients who had drug-susceptibility test result,there were 50 males and 38 females.Of the 88 patients,55(62.5%) had strains resistant to at least one or more anti-drugs.The proportion of TB cases with resistance to a single drug was 12.7%.The multi-drug resistant TB(MDR-TB) rate was 76.4%.The only significant factor for the development of drug resistance and MDR was the history of previous anti TB treatment(P<0.01).Other factors such as age[OR 0.86(0.35-2.13);P=0.72]and gender[OR 1.24 (0.49-3.14);P=0.62]were not significantly associated with drug resistance TB.Conclusions:The study highlighted a high prevalence of MDR-TB among the study population.History of previous TB treatment was associated with MDR-TB.There is an urgent need to conduct a national TB drug resistance survey to determine the actual burden and risk factors associated with drug resistance TB in the country. Objective: To determine the prevalence and risk factors associated with drug resistant tuberculosis (TB) in South West Nigeria. Methods: A retrospective study conducting among pulmonary tuberculosis (PTB) patients from Oyo and Osun States in South West Nigeria who had their culture and drug susceptibility test performed at the institute of tropical medicine Antwerp, Belgium between 2007 and 2009. Data on the patient’s characteristics were retrieved from the TB treatment card. Univariate analysis was performed to assess the risk factors for drug resistant tuberculosis. Level of significance was at P <0.05. Results: Among the 88 patients who had drug-susceptibility test result, there were 50 males and 38 females. Of the 88 patients, 55 (62.5%) had resistant to at least one or more anti-drugs.The proportion of TB cases with resistance to a single drug was 12.7%. The multi-drug resistant TB (MDR-TB) rate was 76.4%. The only significant factor for the development of drug resistance and MDR was the history of previous anti TB treatment (P <0.01). Other factors such as age [OR 0.86 (0.35-2.13); P = 0.72] and gender [OR 1.24 (0.49-3.14); P = 0.62] were not significantly associated with drug resistance TB.Conclusions: The study highlighted a high prevalence of MDR-TB among the study population. History of previous TB treatment was associated with MDR-TB. There is an urgent need to conduct a national TB drug resistance survey to determine the actual burden and risk factors associated with drug resistance TB in the country.