This monograph presents guidelines developed by the Scientific Panel of the Working Group on Directly Observed Treatment, short-course (DOTS)-Plus for multidrug-resistant TB (MDR-TB). The World Health Organization created the Working Group on DOTS-Plus for MDR-TB in 1999. The guidelines describe criteria and technical standards that must be in place before beginning a DOTS-Plus pilot project to treat MDR-TB patients and provide an international standard for the structure and function of pilot projects. Also, the criteria must be met before the pilot project can be supported by international provision of reserve second-line anti-TB drugs at favorable cost and by help from international expertise and monitoring. The annex section includes various strategies that may be used in DOTS-Plus pilot projects.