OBJECTIVE: To investigate the long term survival of MDR-TB patients compared to non-MDR-TB in Henan province in 2010. METHODS: Participants were randomly selected in 2010 from a dataset generated by an anti-TB drug resistance surveillance survey conducted by the Tuberculosis Control Institute, Henan Centre for Disease Control and Prevention in 2001, supported by the World Health Organization. Information on patient's demographic profile and medical records was extracted by trained doctors and nurses at local anti-TB dispensaries. Interviews were carried out using questionnaires to collect information on the socioeconomic features and survival status. Bivariate and multivariate with logistic regression were performed for data analysis. RESULTS: The long term outcome of MDR-TB patients was much poorer when compared to non-MDR-TB patients. The case fatality was much higher among MDR-TB than non-MDR-TB patients (22.1% vs. 6.7%). The risk factors associated with the poorer outcome would include drug resistance status, disease relapse, hospitalization for treatment and long treatment period. Compared to non-MDR-TB, the survival time for MDR-TB was much shorter after having had the disease (6.7 years vs. 8.0 years). CONCLUSION: MDR-TB patients had poor long term outcomes. As most of the cured TB patients were under productive age in the society, the high case fatality rate of MDR-TB would impose big burden on the related family and communities. Findings from this study suggested that the TB control programs should involve more efforts be paid on MDR-TB control, in order to reduce the burden of the disease.