India bears 27% of the global burden of MDR TB. The emergence of drug-resistant TB can be controlled by early diagnosis and well-timed initiation of appropriate &effective treatment regimens guided by newer diagnostic tools. Patient compliance to treatment through effective patient support system and social awareness on the disease is very essential. To counter DR TB in India, PMDT services were introduced in the year 2007 and nationwide coverage was achieved in the year 2013. Recently in March 2021, guidelines for Management of DR TB patients in the country under PMDT have been revised and being implemented under the programme. Upmost emphasis is given for prevention, detection and appropriate treatment by building the quality standards. This article briefly surmises about the burden, programme performance, diagnosis and treatment facets in management of DR TB. Additionally, information about patient support mechanism and ongoing research & clinical trials in this domain are highlighted.