Background: Chronic Suppurative Otitis Media (CSOM) is a persistent inflammatory condition of the middle ear, frequently complicated by bacterial infections that lead to substantial morbidity. The indiscriminate use of antibiotics has resulted in the emergence of multi-drug resistant bacterial strains. Understanding the microbial profile and antibiotic susceptibility patterns is crucial for effective treatment. Methods: A cross-sectional study was conducted on 100 patients diagnosed with CSOM at a tertiary care hospital. Ear discharge samples were collected aseptically and cultured for aerobic bacteria. Microbial identification and antibiotic susceptibility testing were performed following CLSI M100, 2022 guidelines. Data were analyzed using MS Excel. Results: Most patients were male (58%) and aged 16–30 years (33%). The majority presented with unilateral (94%) and tubo-tympanic type CSOM (94%). Mono-microbial growth was observed in 78% of cases, with Pseudomonas aeruginosa (40%) and Methicillin-sensitive Staphylococcus aureus (28%) as predominant isolates. Imipenem and Meropenem were highly effective against Gram-negative bacteria, while Vancomycin and Linezolid showed 100% sensitivity for Gram-positive bacteria. Methicillin-resistant Staphylococcus aureus displayed significant resistance patterns. Conclusion: This study highlights the dominance of Pseudomonas aeruginosa and Staphylococcus species in CSOM and the rise of antibiotic resistance. Regular surveillance of microbial profiles and antibiograms is essential for developing effective empirical treatment strategies and antibiotic stewardship programs.