The emergence of drug-resistant strains of tuberculosis, particularly MDR-TB, is a threat to global efforts to prevent and control tuberculosis. The frequently updated situation of drug resistance and phenotypic resistance patterns of Mycobacterium tuberculosis strains contributed to the success of TB control programs. Objective: To determine to the first line anti-tuberculosis drugs resistance patterns of Mycobacterium tuberculosis strains isolated in Vietnam. Methods: The drug-resistant TB strains were collected from the National Hospital of Tuberculosis and Lung diseases, Hue Centre General Hospital, Pham Ngoc Thach Hospital - Ho Chi Minh city in 20082009. Drug susceptibility testing was done with the first-line anti- B drugs: rifampicin (RIF), isoniazid (INH), streptomycin (SM) and ethambuton (EMB). Results and conclusions: The total of 446 strains showed resistance to at least one drug tested. Streptomycin had the highest resistance (91.5 percent), followed by Isoniazid (78.7 percent) and Rifampicin (72 percent). Most of the isolates were resistant to INH (22 strains) and SM (92 strains), only 3 cases were RIF resistance alone. The percentage of MDR-TB was 71.3 percent. RIF resistance is a valuable surrogate sign for multi-drug resistance and indicates that the second line anti-TB drugs should be used in these cases. There is an urgent need for applying rapid diagnosis methods in cases suspected MDR-TB. Every patient infected with DR-TB needs to be well supporled, treatment compliance, and closely follow-up.