Multi-drug resistant tuberculosis (MDR-TB) is defined by the loss of susceptibility of Mycobacterium tuberculosis complex strains to the two major anti-tuberculosis drugs: isoniazid (H) and Rifampicin (R). This resistance may be acquired or primary. The aim of our study was to describe the epidemiological, clinical, bacteriological and evolutionary profile of multi-resistant tuberculosis patients in Western Algeria. To do so, aretrospective analytical study, which included 36 patients, was carried out in the pneumo-phthisiology department (B) of the Oran University Hospital (West Algeria) from January 2010 to December 2014. Our result showed an average age of 33.7 years. The risk factors for MDR-TB highlighted were tobacco (n=12; 33.3%), alcoholism (n=1; 2.8%) and family history of MDR-TB (n=3; 8.33). Primary MDR-TB was present in 11.11% of cases and secondary MDR-TB in 88.89% of cases. There was resistance to H and R in 13.8% of cases (n=5); to H, R and Streptomycin (S) in 50% of cases (n=18); to H, R and Ethambutol (E) in 5.6% of cases (n=2). The percentage of patients who had lost the sensitivity of the Bacillus to the four first-line anti-tuberculosis drugs (H, R, S, and E) was 25% of all patients tested (n=9) and H, R, S, and Ofloxacin (O) in one case. Five patients died. The rate of primary resistance found in this study constitutes a threat to efforts to control MDR tuberculosis in Algeria. It is therefore important to update the results and assess the extent of the problem.