The incidence of tuberculosis (TB) in New York City has increased significantly over the past decade, with a particular rise in drug-resistant TB cases. A study conducted in April 1991 found that 33% of patients with positive cultures for *Mycobacterium tuberculosis* had resistant isolates, and 19% had isolates resistant to both isoniazid and rifampin. The risk of drug resistance was highest among previously treated patients, those infected with HIV, and injection-drug users. The study also highlighted the high case fatality rate among patients with AIDS and drug-resistant TB, and the importance of ensuring patients complete their treatment to prevent the spread of drug resistance. The New York City Department of Health has implemented measures to control and prevent the spread of drug-resistant TB, including mandatory surveillance, timely laboratory testing, and recommended treatment regimens. The findings underscore the need for improved social and economic conditions to support effective TB control.The incidence of tuberculosis (TB) in New York City has increased significantly over the past decade, with a particular rise in drug-resistant TB cases. A study conducted in April 1991 found that 33% of patients with positive cultures for *Mycobacterium tuberculosis* had resistant isolates, and 19% had isolates resistant to both isoniazid and rifampin. The risk of drug resistance was highest among previously treated patients, those infected with HIV, and injection-drug users. The study also highlighted the high case fatality rate among patients with AIDS and drug-resistant TB, and the importance of ensuring patients complete their treatment to prevent the spread of drug resistance. The New York City Department of Health has implemented measures to control and prevent the spread of drug-resistant TB, including mandatory surveillance, timely laboratory testing, and recommended treatment regimens. The findings underscore the need for improved social and economic conditions to support effective TB control.