Resectional surgery is recommended for patients with localized multidrug-resistant tuberculosis if adequate pulmonary reserve is present. Appropriate drug specific therapy is employed for approximately 3 months preoperatively and for 18 to 24 months postoperatively. Nutrition is emphasized both pre- and postoperatively. Technically, the use of bronchoscopy, double lumen endotracheal tubes, and muscle or omental flaps is stressed. With the above, cure rates should be better than 90%.