ObjectiveTo investigate the baseline condition of initial and acquired drug resistance in patients with pulmonary tuberculosis in Xi’an city, and provide a scientific basis for the prevention and control of drugresistant tuberculosis.MethodsPatients with positive Mycobacterium tuberculosis(MT) culture and received initial treatment and retreatment in tuberculosis clinics of 14 districts (counties) in Xi’an  and Xi’an Chest Hospital in 2015 were included in the study, antimicrobial susceptibility testing of 4 kinds of firstline antituberculosis drugs were performed.ResultsThe overall drug resistance rate of MT in Xi’an city was 31.9%, multidrug resistance rate (MDR) was 7.0%. Drug resistance rate and MDR in initial treatment group were 27.3% and 3.5% respectively, in retreatment group were 59.5% and 28.6% respectively, drug resistance rate and MDR in retreatment group were both higher than initial treatment group (both P<0.001).ConclusionThe overall drug resistance rate of pulmonary tuberculosis patients in Xi’an city is lower than the whole nation, but MDR is slightly higher than the national level, although TB prevention and control work has achieved some success, the situation is still serious, the management of patients with initial treatment should be strengthened to reduce the occurrence of drug resistance.