BACKGROUND: Antimicrobial resistance in uropathogens is increasing globally, particularly in resource-limited settings such as Nepal, limiting treatment options. OBJECTIVES: This study aimed to evaluate the antimicrobial resistance patterns of uropathogens isolated from patients with urinary tract infections (UTIs) in a tertiary care hospital in central Nepal. DESIGN: This study utilized a retrospective study design. METHODS: We retrospectively observed medical records from August 2023 to February 2024 at Manmohan Memorial Teaching Hospital in Nepal, focusing on patients with significant bacterial growth in urine samples and antibiotic sensitivity analysis for resistance trends. CONCLUSION: Empirical therapy, including nitrofurantoin and aminoglycosides, is a viable option for combating antimicrobial resistance in Nepal, necessitating region-specific surveillance and multicentre studies.