Abstract: ObjectiveTo study the first course of anti-TB treatment among multi-drug resistant tuberculosis(MDRTB)patients and to analyze the effects of health service provider and recipient in the treatment.MethodsFive cities were selected as study areas and the populations sampled were surveyed with a self-made questionnaire.ResultsThe sixty-nine MDR-TB patients were mainly older farmers with loweducation.Of the patients,17.3% had their first course of anti-TB therapy in anti-tuberculosis institutions and 43.5% had the first treatment less than 6 months.A certain proportion of patients was prescribed second-line anti-TB drugs in the first treatment and 15.4% of the patients stopped the the treatment voluntarily.Only 36.4% of the patients took their medication under directly observed treatment and 36.4% of the patients received medical visit during the treatment period.After the first anti-TB treatment,11.9% of the patients were cured recognized by doctors.ConclusionThere was substandard therapy management in the first course of anti-TB treatment among MDR-TB patients.The professional training for doctors invloved in TB control,particularly village doctors should be strengthened and appropriate incentives of referral of TB patients should be established.