The article is devoted to actual problems of phthisiology in Russia. It is presented the analysis of reasons for the slow re­gression of tuberculosis in Russia, as throughout the world, the most important of which are multi-drug resistant Mycobac­terium tuberculosis, the increasing spread of HIV infection and the number of adverse social factors. Practical importance of application of modern methods of accelerated drug resistance testing of Mycobacterium tuberculosis to its successful treatment is shown.