The Gene X pert MTB/RIF assay is a novel integrated diagnostic device for the diagnosis of tuberculosis and rapid detection of RIF resistance in clinical specimens. We determined the performance of the MTB/RIF assay for rapid diagnosis of tuberculosis and detection of rifampin resistance in smear-positive and smear-negative pulmonary specimens obtained from possible tuberculosis patients. Study is performed in the centre of Chest & Pulmonary Diseases at Erbil city (Iraq) between November 2013 and May 2015. Three hundred fourteen Sputum samples were obtained from TB suspects. All samples were tested on Gene X pert for MTB/RIF detection after AFB microscopy. 50(15.9%) sputum samples were AFB smear positive and 263 (83.7%) were negative. In MTB/RIF assay 111 (35.3%) were MTB positive and 203 (64.6%) were negative. The MTB/RIF assay also detected 14 RIF-resistant specimen and 97 RIF-susceptible specimens, and the results were confirmed by drug susceptibility testing. We concluded that the MTB/RIF test is a simple method, and routine staff with minimal training can use the system. It helps to avoid injudicious use of anti-tuberculosis drug.).