Objective. Micobacteria resitant to antituberculosis drugs endanger the fight against tuberculosis worldwide. Methods. A retrospective epidemiological study was conducted, based on the observation of the epidemic process of tuberculosis infection in 2006-2017 in Omsk region. We used the data of federal statistical surveillance forms, and also bacteriograms of tuberculosis patients. Results. Against the background of a decrease in the incidence of tuberculosis to 62.2 per 100 thousand of the population, the age structure of newly diagnosed patients was changed: an increase in the proportion of people aged 35-44 from 19.2 to 31.9 %, while reducing the proportion of 18-24 y.o. from 13.8 to 6.1 % and 45-54 y.o. from 21.8 to 13.5 %. The number of patients co-infected with the human immunodeficiency virus (from 1.4 to 22 %) has increased. The incidence of bacterial excretion increased from 39.8 to 56 %. 51.8 % of mycobacterial isolates were characterized by different types of drug resistance. Among newly-detected bacterial invaders, the proportion of patients with multidrug-resistant mycobacteria increased from 24.1 to 30.5 %. The incidence of tuberculosis with extensively drug-resistant tuberculosis was 1.6, and prevalence was 13.6 per 100,000 of population and was characterized by a pronounced upward trend. Conclusions. Under the circumstances, the regional system of epidemiological surveillance will require new approaches to optimization, taking into account changes in the parameters of the epidemic process.