The aim of the study was to determine the prevalence of drug-resistant tuberculosis among children and adolescents in the Republic of Sakha (Yakutia) (RS(Y)) and the features of its clinical manifestation, in order to improve the prevention and treatment of the disease. We monitored a total of 250 children and adolescents with tuberculosis (TB) who underwent inpatient treatment in the Yakut NPZ in 2012-2016: The patients included 34(13.6%) children in the 0-2 age group, 80(32%) in the 3-6 age group, 74(29.6%) in the 7-14 age group, and 62(24.8%) adolescents between 15 and 17 years. The timing of the development of the disease from the time of primary infection with Mycobacterium tuberculosis differed significantly depending on the age of children. In young children, compared with older children, signs of the disease appeared at an earlier time. In the structure of clinical forms of TB, the differences were observed depending on the age of the children: • In children under 2 years, the lesion of intrathoracic lymph node tuberculosis (ITLN) was most common, as well as generalized TB • For children aged between 3 and 6 years, the lesion of ITLN was characteristic • For older children, the different clinical forms of TB were characteristic. The expression of immunological tests depended on the age of the patients and the number of ITLN lesions. Drug resistance to anti-tuberculosis drugs was found in 21 (36.8%) patients; multidrug-resistant TB was mainly registered in adolescents and multidrug resistance was mainly primary. Drug resistance to isoniazid, rifampicin, and streptomycin was the most frequent. Thus, it has been established that the outcome of the disease and the timing of the onset of clinical involution of the disease depend on many factors, including the timeliness of disease detection, the age of the patient, the dissemination of TB process, and others.