Abstract: Urinary Tract Infections (UTIs) in pregnancy is a common medical problem associated with significant increase in the risk of fetal morbidity and mortality. The effective appropriate antimicrobial agent is a major concern as many effective antimicrobial groups cannot be used due to their potential toxicity to the fetus as well as the increasing rates of Multidrug-Resistant (MDR) strain isolation. This crosssectional study was conducted on women attending the antenatal care of Zagazig University. This study aimed to estimate prevalence of various uropathogens in UTI among the pregnant women and determine their antimicrobial resistance patterns. Clean catch mid-stream urine samples were obtained, complete microbiological examination and antibiotic susceptibility testing were carried out. More than half of culture positive samples was obtained from asymptomatic pregnant women. Asymptomatic bacteriuria was more common among primigravida and women of low socioeconomic class. Symptomatic baceruria was more prevalent in women with history of previous Cesarean section. Gram negative bacterial isolates were the most prevalent (71%). The most frequently isolated pathogens were: E. coli 34%, K. pneumoniae 26% and S. saprophyticus 23%, among the total Gram negative isolates, 95.0% were MDR. Meropenem was the antibiotic with the highest susceptibility rate (96%) on E coli isolates, followed by nitrofurantoin (74%) and tobramycin (72%). Recommendations: Urine culture and sensitivity must be the role as MDR pathogens are increasing, rationalization of antibiotic administration is a must.