Abstract: Background: Tuberculosis (TB) is an infectious disease caused by a bacterium called Mycobacterium tuberculosis, which affects the lungs most of all. Multidrug-resistant tuberculosis (MDR-TB) shows resistance to Isoniazid and Rifampicin both of which are the first-line anti-TB drugs. This is one of the critical health concerns all over the world and MDR-TB represents a major threat to control of the disease worldwide because of its high mortality and limited treatment therapy. Methodology: The present study was designed to determine the spread of MDR-TB in Gujrat, Punjab Pakistan. A total of 300 sputum samples were collected from suspected patients at Aziz Bhatti Shaheed Teaching Hospital, Gujrat. All the information regarding patients and their previous history of infection was collected through a predesigned questionnaire. After collection all the sputum samples were directly screened for acid fast bacilli through Z-N and Fluorescent staining. Molecular confirmation of MDR-TB was done by Gene-Xpert MTB/RIF assay. Results: Out of 300 samples 167(55.7%) were male and 133(44.3%) were females among those 149 were new patients and 49 were previously treated patients. ZN staining reveled 153 (51.0%) positive cases and mostly (n=60; 39.2%) were found in 21-40 years age. Moreover, 199 (66.3%) cases were positive for MTB by fluorescent staining and mostly (n=76; 38%) were observed in 21-40years age group. However, 214 (71.3%) MTB cases were identified by Gene-Xpert and among these, 25 (8.3%) were MDR-TB. Out of 25 cases 18 (72%) were females and 07 (28%) were male patients. Conclusion: There was high prevalence of MTB (71.3%) and MDR-TB (8.3%) in clinical setting of Gujrat. Therefore, it is the need of the hour to conduct surveillance study to overcome this problem.