Abstract: Objective To understand the drug resistance in smear positive tuberculosis (TB) patients in Shaoxing, Zhejiang province, and provide evidence for the prevention and control of TB. Methods Mycobacterium tuberculosis strains were isolated from the sputum samples of the TB patients receiving treatment in the hospitals in Shaoxing from 2010 to 2012. The drug susceptibility test of the isolated strains to isoniazid (INH), rifampicin (RFP), ethambutal (EMB) and streptomycin (SM) was conducted. Results In the 3042 sputum culture-positive cases, the overall drug resistant rate was 11.28%. In new cases, the overall drug resistant rate was 9.11%, and in retreated cases, the overall drug resistant rate was 26.60%. The resistant rate to INH was the highest, followed by SM, RFP and EMB. The overall multi-drug resistant rate was 5.33%. In new cases, the multi-drug resistant rate was 2.96%, and in retreated cases, the multi-drug resistant rate was 22.07%. Conclusion In Shaoxing, the overall drug resistant rate of TB was lower than national level, but multi drug resistance was still very serious in retreated TB patients. It is necessary to strengthen the prevention and control of multi drug resistant TB.