INTRODUCTION: Tuberculosis in the PLHIV population is a major cause of morbidity and mortality and presents a substantial hazard of nosocomial disease transmission to other patients and health care workers. These risks are heightened when patients have multidrug-resistant TB. To address these challenges, there is a critical need in such a setting for rapid, ef ective screening for TB and the detection of drug resistance and early initiation of treatment. Delayed treatment is associated with higher morbidity and mortality. METHOD: This was a cross-sectional survey among HIV infected adult patients attending A.R.T Nodal centers, Medicine Opd and ward and chest, and T.B OPD and wards. All the patients with presumptive pulmonary TB were assessed for sputum for microscopy AFB and underwent Drug susceptibility test (CBAAT) for Rifampicin resistance. The primary aim of the Study is “TO EVALUATE PATTERN OF RIFAMPICIN RESISTANCE IN SEROPOSITIVE HIV PATIENTS IN TERTIARY CARE CENTER IN WESTERN UTTAR PRADESH” RESULT: The present study concluded that the prevalence of sputum positive pulmonary tuberculosis is very high of 39% among presumptive pulmonary tuberculosis patients. BY using CBNAAT we found that 27% of rifampicin resistance was prevalent among 78 patients. In the study population maximum sputum, positive pulmonary tuberculosis was in-between age group 31 to 50 years. Majority 81% of the patients were male. CONCLUSION: Sputum microscopy has very low sensitivity (35.9%) in our study for diagnosing tuberculosis in PLHIV. whereas CBNAAT has a sensitivity of 95 %,it detected double numbers of patients than AFB microscop