Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis complex, and the mortality rate is the second highest among the infectious diseases worldwide. The increasing proportion of drug-resistant tuberculosis has become one of the great challenges in eradicating tuberculosis. The traditional diagnosis method of drug resistance is based on culture, which takes time, effort and high technical requirements. Existing molecular detection methods can only detect a small number of anti-tuberculosis drug resistance genes, so a better understanding of anti-tuberculosis drug resistance mechanisms will contribute to a comprehensive resistance diagnosis. This article summarizes the research progress on eleven first- and second-line anti-tuberculosis drugs and their corresponding drug resistance-related genes and mutation sites. Recent studies on second-line drugs such as cycloserine, linezolid, and clofazimine have been systematically described, providing a preliminary basis for the study of comprehensive drug resistance diagnosis, accurate guidance for treatment, research and development of new drugs, and in-depth drug resistance mechanisms.