Introduction: Antibiotic resistance is one of the alarming issues, affecting human health Pseudomonas aeruginosa is a prototype of “multidrug-resistant pathogen” and is recognized for its ubiquitous distribution, advanced antibiotic resistance mechanisms, and nosocomial infections. The organism is classified into various phenotypes based on the drug resistance pattern, namely, drug-resistant (DR), multi-drug resistance (MDR), and extensively drug resistance (XDR). This study aims to find out the changing trends in the prevalence and antibiotic resistance patterns of urinary isolates of Pseudomonas aeruginosa Material and Methods: This prospective study was started from January 2020 to June 2020 in department of Microbiology in Pacific Medical College and Hospital in Udaipur, Rajasthan. The culture reports which were positive for significant growth of Pseudomonas aeruginosa were analyzed to find out its prevalence and antibiotic resistant patterns. In our research study we have analyzed 500 samples of urine and isolated 100 samples of Pseudomonas aeruginosa. Descriptive statistics was used for data analysis. Clinical and Laboratory Standards Institute (CLSI) guidelines were followed to determine the results. Result: Pseudomonas aeruginosa was isolated in 100 out of 500 urine samples. Antibiotic resistance studies revealed that 57.51% of Pseudomonas aeruginosa isolates showed drug resistance. The frequency of multi drug resistance Pseudomonas aeruginosa isolated from urine sample was found to be 42.49%. The antibiotic resistance observed were as follows Amikacin (16.4%), Colistin (17.4%), Imipenem (20.8%), Polymyxin (21.2%), Piperacillin (36.7%), Levo floxacin (43.3%) ,Piperacillin+ tazobactum (48.2%), Tobramycin (58.2%), Ciprofloxacin (65.6%), Gentamycin (69.1%), Ceftazidime (78%), Cefotaxime (82%) Amikacin was found to be the most effective antibiotic, followed by Carbapenem group of drugs. Conclusion: Pseudomonas aeruginosa remains as a common uropathogen. Drug resistant strains are markedly high. Our data revealed a high prevalence of drug resistance of Pseudomonas aeruginosa in the total isolate of Pseudomonas aeruginosa. There is an urgent need to resolve the issue by taking some preventive measures. Combined efforts of health care profess ion als and researchers are required to educate people about the proper use of an tibiotics and otherin fection contro lmeas ures Keywords: Pseudomonas aeruginosa, Antimicrobial resistance, Multi drug resistance, Drug resistance