Aim: Assess the Causative agents, Systemic Risk Factors, and antimicrobial Sensitivity of Keratitis Infection Among Patients Admitted at Madhubani medical college and hospital, Madhubani, Bihar. Material and methods: A quantitative, non-experimental research design is an analytical cross-sectional study. This type of research aims to "collect data from a group of subjects at only one point in time. A total of 400 people met the inclusion criteria, and a researcher was selected to conduct the primary study form January 2023 to December 2023. In the end, 400 patients were present throughout the full data collection process. Patients of all sexes and ages who have been diagnosed with infectious keratitis are included in this category. Demographic data like Age, Gender, Occupation, Area of residency, Co morbid illness associated with Keratitis, Medications used, Trauma factors. The methods used for Specimen processing wet mount, Potassium hydroxide Method, Grams staining, Culture and Sensitivity testing were performed. Results: 35% of the patients were not using any medication, while 4.5% were using Corticosteroids. 80.5% of the patients associated risk factor were trauma, while 4. % were associated with the use of contact lens. 80.5% of the were infected with fungi andonly3% clients were infected with virus. It shows that 79% of the patients were positive in KOH Method , while 21 % were negative. Majority 24.68% of the Isolated Fungal species are A. fumigatus. and the least isolated one was 1.26%Fonsaceapederosoi. Table-6 It shows that 13.25 % of the patients sample reveals the presence of bacteria , while 86.75 % were negative. Majority56.60% of the gram+Ve bacteria are S. aureus. and the least isolated one was 1.88% from gram -Ve. ie A. baumannii. It shows that wet mount 3.25% (13) was positive among participants , and none of them in culture positive. Majority83.33% are Herpes simplex virus. and the least isolated one was 16.67% from Varicella zoster virus. 19.30% of the sample were resistance to Natamycinc But all samples were susceptible to ketoconazole. S.aureus isolates MSSA and MRSA 50%.It also reveals that MRSA AND MSSA isolates linezolid 100%and in MSSA , Chloramphenicol and penicillin were 100% resistant. P. aeruginosa isolates Aztreonam and Meropenem 100%. E. coli isolates all antibiotics except Ampicillin and cotrimoxazole shows 100% resistance. K. pneumoniae susceptible to three medicines, they are Imipenem, Ciprofloxacine and meropenem and all other medicines shows 100% resistance. K. pneumoniae susceptible to all medicines, except cotrimoxazole and ampicillin shows 100% resistance. Conclusion: Fungal corneal ulcers were found to be more common than bacterial corneal ulcers in this study. Because ofour country's tropical environment, which is both warm and humid, this is understandable. Simple bedside diagnostics, such as direct Gram staining or KOH mount and PCR test can provide valuable information on the type of the infectious agent and can assist doctors in selecting the most appropriate antibiotic treatment.