Objectives: To analyze the geospatial distribution of drug-resistant tuberculosis cases in Loreto during the period 2015–2024. Methodology: Observational study with a cross-sectional and retrospective design, which evaluated the geospatial distribution of 409 cases of drug-resistant tuberculosis in the Loreto region between 2015 and 2024, using QGIS software version 3.28.4 and Kernel density analysis. Results: Most cases were concentrated in the province of Maynas (88.3%), particularly in the districts of Iquitos, Belén, and San Juan Bautista. High-density geographic clusters were identified in urban areas, with a progressive shift toward peripheral zones starting in 2019. Multidrug-resistant tuberculosis (MDR-TB) accounted for 51.1% of cases, and the most frequent comorbidities were diabetes (23%), malnutrition (18.6%), and HIV (11.5%). Conclusion: A heterogeneous and focal geospatia...