Tuberculosis is one of the major unresolved global health problems. Rapid diagnosis of TB as well as rapid detection of drug resistance is essential for both the treatment and control of the disease. The microscopic observation drug susceptibility (MODS) assay is a relatively low-cost method. The purpose of this study was to evaluate the performance of MODS assay for the detection and diagnosis of MDR-TB. The study was conducted on 100 patients using 100 sputum samples. The current study proves MODS assay as a rapid test of high accuracy for the diagnosis and susceptibility testing of M. tuberculosis