【Abstract】 Objective To investigate the main cause and clinical prevention strategies of liver injury in the drug resistant pulmonary tuberculosis patients during the antituberculosis treatment. Methods 82 drug resistant pulmonary tuberculosis patients in Yongchuan Hospital of Chongqing Medical University were retrospectively analyzed. The clinical data of the patients were observed. 15 patients in the preventive group were treated with reduced glutathione, 67 patients in the control group without reduced glutathione. The number and cause of liver injury shown in 82 patients were investigated for 8 weeks. Results Of all the 82 patients after antituberculosis treat, 23 patients (280%) shown liver injury. Of the 67 patients in the control group, 21 patients (313%) shown liver injury. While, of the 15 patients in the preventive group, only 2 patients(133%) of them suffered from liver injuryOf 23 patients with liver injury, 8 patients accompanied with chronic hepatitis B or C, 1 patient with acute hepatitis E, 1 patient with autoimmune hepatitis, and 3 patient with alcoholic liver disease. Conclusion The drug resistant pulmonary tuberculosis patients appeared high incidence of liver injury during the antituberculosis treatment. The drug resistant pulmonary tuberculosis patients should be received liverprotecting and considered that patients accompanied with chronic hepatitis B or C when liver injury