Abstract: Bacterial resistance has become a serious problem that the whole world is facing.Routine bacterial drug resistance testing methods such as K-B test and dilution method are time-consuming and incapable to identify the specific drug resistance mechanism , which can not meet the needs of clinicians. MALDI-TOF MS overcomes the shortcomings of traditional methods and has broad application prospects in detection of bacterial resistance and drug resistance mechanism.This article reviews the recent progress on the application of MALDI-TOF MS in detection of bacterial drug resistance mechanisms.