Background: Antimicrobial resistance (AMR) is a growing global concern, particularly in pediatric bacterial infections, where limited treatment options pose a significant challenge. Understanding resistance patterns is essential for guiding empirical therapy and infection control strategies. This multi-centre study aims to analyze the antimicrobial resistance profiles of bacterial pathogens isolated from pediatric patients across various healthcare facilities. Methods: A cross-sectional study was conducted in five tertiary care hospitals from January 2023 to December 2023. A total of 500 clinical samples, including blood, urine, respiratory secretions, and pus, were collected from pediatric patients aged 0–16 years with suspected bacterial infections. Bacterial isolates were identified using standard microbiological techniques, and antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method in accordance with CLSI guidelines. Statistical analysis was carried out using SPSS v25, with resistance trends analyzed for common pathogens. Results: Among the 500 samples, 350 (70%) yielded bacterial growth. The most common isolates were Escherichia coli (40%), Staphylococcus aureus (25%), Klebsiella pneumoniae (15%), Pseudomonas aeruginosa (10%), and Streptococcus pneumoniae (10%). Resistance to commonly used antibiotics was observed, with E. coli showing 65% resistance to third-generation cephalosporins and 40% to fluoroquinolones. S. aureus exhibited methicillin resistance in 50% of isolates. Multidrug resistance (MDR) was noted in 60% of Gram-negative and 45% of Gram-positive isolates. Conclusion: The high prevalence of antimicrobial resistance in pediatric bacterial infections highlights the need for stringent antibiotic stewardship programs and continuous surveillance. Empirical therapy should be tailored based on local resistance patterns to improve treatment outcomes and reduce AMR burden.