Multidrug-resistant tuberculosis(MDR-TB), resistant to at least the two main TB drugsisoniazid and rifampicin, has been a threat to TB control because the treatment requires more toxic drugs and longer period with poor treatment outcomes. Recently, more serious concerns have been raised about extensively drug resistant-tuberculosis (XDR-TB), which shows resistance to fluoroquinolones and aminoglycosides in addition to isoniazid and rifampicin. XDR-TB is a serious global health threat because the cure is very difficult as few sensitive anti-TB drugs remain. XDR-TB develops when first-and second-line anti-TB drugs are misused during the course of treatment, most commonly due to poor compliance of the patients to the treatment regimen. People with XDR-TB can pass the XDR-TB bacteria to other people. Thus, every effort should be made to prevent the development of XDR-TB by establishing an effective TB control program maximizing patient adherence to prescribed anti-TB regimen and minimizing contact of XDR-TB patients with other people to prevent the spread of XDR-TB.