Background: Tuberculous pleural effusion (TPE) is among the most common forms of extra-pulmonary tuberculosis. India is such country which is classified as the highest multi drug resistance burden overall. There is limited information available regarding the drug resistance patterns in TPE, especially from high burden countries. This can be due to difficulty in obtaining specimens and limited facilities for drug susceptibility testing. Aims and Objectives: This study was aimed to determine the culture positivity rate of tuberculous pleural effusion and detection of drug resistant pattern associated with it. Materials and Methods: Retrospective study of 469 Pleural effusion samples from suspected patients from January 2020 to December 2021 at the TB Culture & Drug Susceptibility Laboratory attached to a tertiary care center, Jamnagar was done. Samples processed for CBNAAT followed by liquid culture. Positive culture isolates were checked for drug resistance in First Line-Line Probe Assay (for Rifampicin and Isoniazid) and Second Line- Line Probe assay (for Flouroquinolones and second line injectable drugs Amikacin, Capreomycin, Kanamycin). Results: Culture positivity rate was seen 7.03%. Among these, Rifampicin resistance was 9.09 % and isoniazid resistance was 12.1%. Resistance to Fluoroquinolones was 33.33% and no resistance seen to second line injectable drugs. No MDR-TB or XDR-TB detected in present study. Conclusion: In our present study we have found that there is an increase trend of resistance to Anti-TB drugs which needs atmost attention and necessary steps have to be taken in early diagnosis and in administration of drug therapy among the patients in whom pleural TB is being suspected. For this Novel molecular techniques can help in early diagnosis and treatment to prevent disease progression and amplification of resistance.