〔Abstract〕 Objective To investigate the status quo of drug resistance and influencing factors of tuberculosis in Inner Mongolia, and to provide reference for accurate prevention and control of drug-resistant tuberculosis. Methods Random sampling was used in this study. TB patients from Tuberculosis designated hospital in Inner Mongolia were included, according to the rules and drug-resistant strains were identified and tested according to relevant norms. Composition ratio or rate was calculated for statistical description, and Logistic regression model was used to analyze the influencing factors of drug resistance in TB patients. Results Among 1 321 patients, there were 936 males and 385 females, with an average age of(52.65±18.09) years. The rates of mono-resistant, multidrug-resistant(MDR), extensively drug-resistant(XDR) and total drug resistance were 19.00%, 11.58%, 11.66% and 42.24%, respectively. The highest resistance rates were observed for streptomycin(7.27%), isoniazid(4.69%), and isoniazid + streptomycin(4.47%). The drug resistance spectrum presented diversity and complexity. Compared to females, males had a higher proportion of drug resistance, and the difference was statistically significant(P<0.001). The proportion of patients who were sensitive to anti-tuberculosis drugs increased with age(P<0.05). Among different age groups, the proportion of drug-resistant patients was higher in the 20-40 age group, 40-60 age group, and 60 and above age group compared to the 0-20 age group(P<0.05). Additionally, the proportion of drug-resistant patients was higher in the 20-40 age group and 40-60 age group compared to the 60 and above age group(P<0.05). Moreover, the proportion of drug-resistant and multi-drug resistant patients was higher among patients undergoing retreatment compared to those undergoing initial treatment(P<0.001). Multivariate Logistic regression analysis showed that male gender(OR=1.48, 95%CI: 1.02-2.14), age 20-40 years(OR=2.64, 95%CI: 1.05-6.60), retreatment(OR=2.34, 95%CI: 1.70-3.22), and outpatient follow-up(OR=1.56, 95%CI: 1.05-2.33) were independent risk factors for drug-resistant tuberculosis. Conclusion Inner Mongolia has a high prevalence of MDR and overall drug-resistant tuberculosis among patients. The drug resistance profile exhibits diversity and complexity. Risk factors that contribute to drug resistance include being male, aged between 20 and 40, undergoing retreatment, and receiving outpatient follow-up. Therefore, it is necessary to further improve clinical diagnosis and treatment, promote rational use of first-line anti-tuberculosis drugs, prioritize individualized treatment, enhance health education, improve the medical insurance system, and optimize patient management approaches in order to enhance patient compliance.