Drug resistant tuberculosis (TB) represents an increasing fraction of incident TB cases globally and is associated with prolonged treatment, severe adverse effects, and high mortality. The focus of the seminar will be on drug-resistant TB and especially on extensively drug resistant tuberculosis (XDR-TB). This session will review the changing epidemiology of drug-resistant tuberculosis, advances in the diagnosis, and treatment of TB. We will use a case presentation format to engage the audience and discuss how new diagnostics including next generation sequencing and new and repurposed medications can be used in the management of complex drug-resistant TB.