Aim: This study aimed to determine the prevalence, risk factors, microbial profile, and antibiotic susceptibility patterns of urinary tract infections (UTIs) among pregnant women attending the antenatal clinic of a tertiary care hospital. Material and Methods: A prospective observational study was conducted on 100 pregnant women aged 18–45 years attending antenatal care. Clinical information, including demographic details, obstetric history, and UTI symptoms, was collected through structured interviews. Midstream clean-catch urine samples were analyzed using macroscopic, microscopic, and culture methods. Significant bacteriuria was defined as ≥10⁵ colony-forming units (CFU)/mL. Antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion method as per CLSI guidelines. Results: The prevalence of UTI was found to be 30%. Significant risk factors included history of prior UTI (p<0.001), poor personal hygiene (p=0.05), diabetes mellitus (p=0.02), and lower socioeconomic status (p=0.03). The most common uropathogen isolated was Escherichia coli (60%), followed by Klebsiella pneumoniae (20%) and Staphylococcus saprophyticus (10%). Antibiotic susceptibility testing revealed that Nitrofurantoin (90%) and Ceftriaxone (85%) were the most effective antibiotics, while Trimethoprim-Sulfamethoxazole (50%) showed concerning resistance. Conclusion: UTIs remain a significant health concern among pregnant women, with Escherichia coli as the predominant pathogen. Nitrofurantoin and Ceftriaxone demonstrated the highest efficacy in treatment. Addressing risk factors, promoting routine screening, and ensuring proper antibiotic use are essential for preventing complications and improving maternal and fetal health outcomes.