Introduction: Multidrug‑resistant tuberculosis (MDR‑TB) is an emerging public health problem. The study was done to evaluate the clinical profile of MDR TB patients and to study the diagnostic parameters in a cohort. Materials and Methods: All MDR‑PTB patients admitted in a tertiary level TB institute for initiation of treatment for study period were enrolled. Various clinical parameters such as symptomatology profile, past treatment details, details of diagnosis, and methods of diagnosis were studied retrospectively in these patients. Results: A total of 125 patients were enrolled. An average age was 29.5 ± 12.2 years. The average duration of chest symptoms was 2.4 ± 0.6 years; cough and expectoration were the most common symptoms present in all (100%) the patients. Two patients were treatment naïve, and 123 were retreatment cases, in which, 63 were relapse, 42 were treatment after default, and 18 were failure cases, just prior to being diagnosed as MDR‑TB. Forty‑three patients have received at least one of the reserve line drugs as part of anti‑TB treatment in past. The average courses of treatment taken prior to been labeled as MDR‑TB were 3.15 times. Majority of patients (99) had been diagnosed by using molecular‑based tests. Conclusion: Use of reserve line drugs is common for treatment of TB, even without being diagnosed as MDR‑TB. Both physicians‑ and patient‑related factors responsible for the development of MDR‑TB may be prevented by improving understanding of the disease and by early and proper treatment of both drugs susceptible and drug resistant TB.