Introduction: the estimated worldwide incidence of MDR-TB in 2010 was 650,000. Pulmonary resection combined with chemotherapy had high cure rates in MDR TB. But the role of pneumonectomy in cases of cavitary MDR-tubeculosis 2-sided MDR-TB is not clear for now days. The aim: to determine the role of pneumonectomy in cases of cavitary tubeculosis of lung and focal tuberculosis of contralateral lung. Material: during 2012 10 patients were included in trial. All patients were treated during previous 1 year chemotherapy according to susceptibility. Sputum smears were positive full time. 6 males and 4 females. 10 pneumonectomy were done: 7 right-sided and 3 lett-sided. After operation every 2 month sputum smears were done. Results: postoperative period was uncomplicated in 7 cases. In 3 cases was hemothorax, witch require VATS-procedure. Mean time of postoperative period was 35+|-10 days. Complication rate – 30%. Histology revealed in one case specific inflamation in linea of resection and caseation of mediatinal lymph nodes. Long-term results: one-year survival – 100%. Sputum smears for acid-fast bacilli are negative during all postoperative period in 9 cases. Only 1 patient with specific inflammation and caseation of mediastinal lymph nodes hade progression of TB and continuing of positive sputum smears for acid-fast bacilli. Rate of conversion is 90%. Conclusion: we have no sufficient data for statistical analysis. But the results of conversion and acceptable of complication rate are promising. Pneumonectomy in cases of cavitary MDR-tubeculosis of lung and focal tuberculosis of contralateral lung it can give a chance for conversion of sputum smears.