Drug-resistant tuberculosis (DR-TB) is a case of tuberculosis caused by Mycobacterium tuberculosis (M.TB) resistance to isoniazid (H) and rifampicin (R) with or without other drug resistance. To report a case of DR-TB in a scleroderma woman. A 55-year-old woman came to the hospital with complaints of coughing up phlegm accompanied by blood, shortness of breath, and fever accompanied by weakness, swelling of the eyes and mouth and reddish spots all over the body which she has felt since the last 3 months. History of tuberculosis in 2018. History of scleroderma in 2022 and received therapy from Dermatovenerology and Internist. Physical examination found moderate pain, with 90% saturation without modality, respiration 24 times per minute, other vital signs within normal limits. Lung examination revealed crackles in both hemithorax. Dermatological status in the facial region, axilla region, anterior and posterior trunk region found: multiple nodules and felt hard. Examination of the sputum rapid molecular test (RMT) on January 18, 2023 obtained the results of MTB detected medium, Rifampicin Resistance Detected. Management: the patient was treated with long-term regiment antituberculosis DR and provided a good respiratory clinical response. Early diagnosis of pulmonary tuberculosis in scleroderma greatly determines the prognosis. The patient was treated with long-term antituberculosis DR and gave a good respiratory clinical response.