Background: Multi drug resistant tuberculosis (MDR-TB) is an emerging challenge for TBrncontrol programs globally. Ethiopia is among the 30 High TB, HIV and MDR-TB BurdenrnCountries in the world. Development of drug resistance is hugely man-made problemsrnresulting inadequate treatment due to suboptimal adherence, and continued transmission ofrnresistant strains in the community. Updated knowledge of the associated factors of MDR-TBrnis so substantial to allocate resources, and to address prevention and control measures.rnTherefore, the objective of this study was to identify associated factors of multi-drug-resistantrntuberculosis in among newly diagnosed patients and treated at ALERT Hospitals AddisrnAbaba, Ethiopia, between August 1 2020 and September 30 2020.rnMethod: A health facility based case-control study was conducted to assess sociorndemographic, behavioral and clinical risk factors using a structured questionnaire and clinicalrnrecord reviewing. Analysis were performed using SPPS software and to identify associationrnbetween dependent and explanatory variables logistic regression analysis were performed andrnstatistically significant associations were described using odds ratio at 95%CI and P- value ofrn< 0.05.rnResult: A total of 120 respondentsâ€™ (40 newly diagnosed MDR-TB cases and 80 drugrnsusceptible pulmonary TB patients, control) were enrolled in this study. Number of rooms perrnhousehold (AOR=3.61, 95% CI=1.2-10.6), history of previous treatment (AOR=12.77, 95%rnCI=4.2-38.6) and TB contact history (any type of TB) (AOR=7.62, 95% CI=2.3-25.4) wasrnsignificantly associated with MDR TB infection.rnConclusion: This study revealed that having history of previous anti-TB treatment exposure,rnliving in only one room house hold and having previous TB contact history were identified tornbe the determinants of MDR-TB infection.rnIn light of these findings, the strategies in controlling MDR-TB should come up with rnemphasize on peoples or patients having history of previous TB treatment, TB contact historyrnand those living in houses with only one room (crowded places). Moreover, Implementationrnof adequate TB infection control practices at health facilities is importance.