Tuberculosis is considered as social problem due to its communicability. Several socio-economic and behavioral factors are associated with tuberculosis which may turn into multidrug resistant tuberculosis (MDR-TB) in some favorable contexts. The objective of the study was to determine the associated factors of MDR-TB among adult TB patients in Rajshahi division, Bangladesh. It was a cross sectional study from June 2014 to October 2018 in different facilities of Rajshahi division. Socio-economic, demographic and behavioral variables were collected through face to face interview. Chi-square test and binary logistic regression were used in this study. Out of 410 respondents, 48.8% was MDR-TB and 51.2% was drug susceptible TB. This study revealed that family size, income, expenditure, diabetes and religion were significantly associated with MDR-TB. Binary logistic regression model demonstrated that large family size (≥5 members) had more chance to get MDR-TB [AOR= 0.591, CI: 0.388-0.900, p<0.05] than their counterpart. Higher income group had less chance to get MDR-TB than less income groups. Non-Muslims were more likely to get MDR-TB than Muslim [AOR=0.421; CI: 0.179-0.986, p<0.05]. In this study, income, expenditure, large family size and religion were found as risk factors for developing MDR-TB. These findings can be considered to reduce MDR-TB in Bangladesh.