The conversion of BTA and breeding examination is an indicator of monitoring TB MDR treatment where the condition of Mycobacterium tuberculosis at the same rime indicates negative result in the examination of breeding and BTA. The objective of the research was to find out some factors which influencer TB MDR patient at RSUP H. Adam Malik Medan in the period of 2020 - 2021. The descriptive observational research was analytical with cross-sectional design. The population was 104 TB MDR patients at RSUP H. Adam Malik who began their medication in the period of 2020 - 2021 and 50 respondents were in samples. The data were analyzed by using univatriate analysis and  bivatriate analysis with chi-square statistical test (α=0.05). The results of the bivariate analysis showed that the variables were medication adherence (p=0.007) (p=0.001), medication side effects (p=0.047) (p=0.008), medication swallowing supervisor (p=0.001) (p=0.028), and distance to health services (p=0.025) (p=0.047) had significant influence on convertion of BTA and breeding TB MDR patient. It is recommended that the agencies providing health service facilities will improve services at health facilities, improve access to TB MDR treatment, and provide counseling for handling drug side effects. To TB MDR patients to regularly take medication, consult if there are side effects, and control regularly until treatment is done. For the whole community to adopt a clean and healthy lifestyle.