Tuberculosis (TB) is an infectious disease caused by the bacteria Mycobacterium tuberculosis. It mainly affects the lungs and spreads from person to person through the air. Common symptoms of pulmonary tuberculosis include a prolonged cough, chest pain, weakness or fatigue, weight loss, fever, and night sweats. Significant efforts have been made to control and eliminate TB, which is treatable with a standard short course of therapy. However, the emergence of drug resistance is a major threat to global efforts to end TB. The BPaLM (Bedaquiline, Pretomanid, Linezolid, and Moxifloxacin) regimen represents a significant advancement in DR-TB (Rifampicin-Resistant Tuberculosis/Multi-Drug Resistant Tuberculosis/Extensively Drug-Resistant Tuberculosis) treatment, offering a 6-month, all-oral medication with the potential for improved outcomes and patient experience compared to conventional longer regimens. In spite of the promising results from clinical trials, there are still gaps in our understanding of the real-world effectiveness and safety of the BPaLM regimen, notably in diverse settings with varying healthcare infrastructures and patient populations. This study aims to meticulously collect data on treatment adherence, adverse events, culture conversion, and final treatment outcomes, which might not be consistently captured in routine programmatic data. As there is a scarcity of efficacy and safety data on the components of the BPaLM regimen in the Indian population. Therefore, by filling this critical knowledge gap, the study will contribute to the improvement of global and national TB programmes. An adequate number of subjects will be screened and selected as per the inclusion and exclusion criteria of the study after approval from the Institutional Ethics Committee (IEC), UHS Rohtak will be enrolled. A patient information sheet will be provided to every eligible subject for the study, and thereafter, an informed written consent and assent, if applicable, will be taken from the subjects of this study. The subject’s details will be recorded in the case record form. At the beginning of the study, all subjects confirmed as DR-TB will undergo a detailed history (smoking, comorbidities, h/o previous TB treatment, use of other medications, substance abuse), clinical examination, and systemic examination, and relevant investigations, including CBC, LFT, and renal function, will be enrolled for the study.