In a longitudinal study in a first-level hospital in Luanda, Angola, we found rifampin-resistant and multidrug-resistant tuberculosis (TB) in 38 (8%, 95% CI 5.7-10.8) of 474 patients with no previous history of TB. Of note, 2 patients (0.4%, 95% CI 0.1-1.5) demonstrated pre-extensively drug-resistant TB.