Objective：To investigate the incidence and influential factors of retreatment smear of positive multidrug resistant tubercu－losis patients in Hainan province，and to provide reliable scientific basis for the prevention and control of multidrug-resistant tuber－culosis（MDR-TB）. Methods：From January 2014 to December 2016 ，a total of 694 cases of retreatment smear of positive tuberculosis patients were found in 18 cities and counties of Hainan province. Sputum samples were tested for drug susceptibility test to find the multidrug－resistant tuberculosis patients，and the multidrug－resistance rate was described. Chi-square test and an unconditioned lo－gistic regression were employed to analyze the influential factors of MDR-TB. Results：The retreatment smear positive MDR-TB rate was 18.4%（128/694）. The MDR-TB rates from 2014 to 2016 were 20.9%（49/234），16.2% （39/241） and 18.3%（40/219），and there was no significant difference of MDR-TB rate in the past 3 years in Hainan province（ ?字2=1.793，P>0.05）. The multivariate logistic analysis results showed that the agriculture（OR=1.692，CI=1.047 to 2.734，P<0.05），living in the western region（OR=1.588，CI=1.266 to 1.992，P<0.05），low family income（OR=2.153，CI=1.300 to 3.567，P<0.05），more than once prior anti-TB treatment（OR=1.860，CI=1.222 to 2.831，P<0.05），selecting private hospitals or individual clinics for first health care seeking（OR=1.668，CI=1.128 to 2.467，P<0.05） were found to contribute to higher trend of MDR-TB. Conclusion：The epidemic situation of MDR-TB in Hainan province is close to the national average level. The results indicate that agriculture，living in the western region，low family income，selecting private hospitals or individual clinics for first health care seeking and repeated treatment maybe the risk factors of multidrug resistance.