Multiple drug resistance (MDR) to widening range of antibiotics emerging in increasing variety of pathogenic bacteria is a serious threat to the health of mankind nowadays. This is partially due to an uncontrolled usage of antibiotics not only in clinical practice, but also in various branches of agriculture. MDR is affected by two mechanisms: (1) accumulation of resistance genes as a result of intensive selection caused by antibiotics, and (2) active horizontal transfer of resistance genes. To unveil the reasons of bacterial multiresistance to antibiotics, it is necessary to understand the mechanisms of antibiotics action as well as the ways how either resistance to certain antibiotics emerge or resistance genes accumulate and transfer among bacterial strains. Current review is devoted to all these problems.