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The emergence of antimicrobial resistance is causing the loss of what was once considered the miracle cure. The transmission of antimicrobial resistance during mass gathering is a potential threat in addition to other infectious diseases. Here, we review the English language literature on the rate and the acquisition of antimicrobial resistance during the Hajj. There is a variable incidence of methicillin-resistant <i>Staphylococcus aureus</i>, <i>Escherichia coli</i>, and Enterobacteriaceae. There had been no report of multi-drug-resistant <i>Mycobacterium tuberculosis</i>. Continued surveillance of antimicrobial resistance coupled with public health measures are needed to decrease the rate of emergence of resistance.