OBJECTIVES: Multidrug-resistant tuberculosis (MDR-TB) is designated an orphan disease in Germany, with less than 100 patients per year. TB case reporting has been obligatory since 2001 due to the Protection against Infection act (IfSG). The objective of this study was to compare the incidence of MDR-TB from different epidemiological data sources in Germany with data collected by the Robert-Koch-Institute (RKI) according to the legal requirement.  METHODS: The following potential sources of epidemiological data of MDR-TB in Germany (for the year  2012) were searched:  a systematic review of the literature, data from a statutory sickness fund (SHI) and data from the Federal Office of Administration (BVA) used for the risk adjustment scheme (Morbi-RSA) in the social health insurance system. Data from these sources were then compared with those collected by the RKI. RESULTS: The systematic literature review provided 445 relevant abstracts which were screened by two independent reviewers. Selection of 16 possible full text papers revealed no relevant publications on MDR-TB in Germany. Data from sickness funds as well as the BVA also showed no reported cases of MDR-TB, although both gave indications on the incidence of drug-sensitive TB (91 cases/100,000 & 52 cases/100,000, respectively). The data provided by the RKI reported 4,187 cases of TB (incidence:  5.2 cases/100,000) of which 65 cases (2.3%) were MDR-TB.  CONCLUSIONS: Two factors are most striking: reports specific to MDR-TB are generally hard to find in SHI databases due to a lack of specific ICD-10 codes, but can be approximated with ICD-10 codes for drug-sensitive TB plus medication use. Furthermore, information on TB incidence differs widely among the various data sources in Germany, possibly due to the different ways in which data are collected.