Introduction: - In the ongoing battle against Tuberculosis, the emergence of drug-resistant Tuberculosis posed a significant challenge it to treatment and its control. Drug resistant Tuberculosis is not only difficult to treat, leads to higher morbidity and mortality, higher cost and complexity. According to global tuberculosis report 2022, multidrug resistant rifampicin resistant (MDR/RR-TB) was 3.6% among new cases and 18% among previously treated patients. MDR –TB prevalence in India was 3% and previously treated 35%.

Aim and objectives: - The goal of the current study is to determine the prevalence of Rifampicin resistance among Pulmonary Tuberculosis patients in the Rohilkhand region as well as to compare the diagnostic.

Materials and Methods: - This was a retrospective, observational record-based cross-sectional study conducted from January 2021 to December 2022 in a tertiary healthcare institution situated in the Bareilly, Uttar Pradesh India. The study population was all sputum smear-positive symptomatic patients, all presumptive Pulmonary TB patients and suspected by clinical investigation, visited to the DOT centre during the study period.

Results: - This study comprised 295 sputum samples in which 233 of these were found to be positive and 62 to be negative using fluorescence microscopy. 208 sample had confirm Mycobacterium tuberculosis by GeneXpert MTB/RIF or Cartridge Based Nucleic Acid Test (CBNAAT). While 87 samples were negative. 15 isolated cases of rifampicin resistance which was prevalence rate was (7.22%). According to GeneXpert MTB/RIF, eight patients from previously treated cases and 7 cases from recently identified cases of pulmonary tuberculosis exhibit Rifampicin resistance. The findings indicate that men are more vulnerable than women to have pulmonary tuberculosis.