An ongoing outbreak of world’s first extensively drug-resistant (XDR) typhoid fever has been reported in Pakistan which does not respond to most of the available antibiotics. The earlier case of XDR typhoid was reported in Hyderabad in November 2016. Several cases have also been in the United Kingdom and in the United States among the people who visited Pakistan during 2018. In 2019, the outbreak has spread to the multiple cities of Pakistan and several deaths have been reported. Karachi and Hyderabad being the most affected cities where the majority of cases (96%) been reported.Typhoid fever is caused by a bacterium Salmonella Typhi, which infects the intestinal tract and can be treated by several antibiotics. But the type of bacterial strain responsible for XDR typhoid fever in Pakistan does not respond to most antibiotics used to treat conventional typhoid fever (ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, ciprofloxacin, and ceftriaxone). One of the major causes of the resistant in the circulating strain of XDR Salmonella Typhi is the extensive use of antibiotics by the South Asian population. Health official is trying to identify the possible cause of this outbreak. Vaccination and awareness campaigns have been started to minimize its spread.Preventive precautions of the XDR typhoid fever should be taken every day; Wash your hands often, especially before eating and after using the washroom.Boil water before drinking or disinfect it by any other mean.Avoid eating food prepared by someone who is sick or has been sick.Avoid street food.Raw fruits or vegetable should be avoided unless you can peel them or wash them with clean water.Avoid outside salads if possible as shredded or finely cut vegetable offer a lot of surface area for germs to grow on.Avoid raw meat or seafood as they may contain germs.