Back ground:-Urinary tract infections (UTIs) are among the most common bacterial infections in children and may lead to significant complications if not diagnosed and treated promptly. Knowledge of the local microbial profile and antimicrobial susceptibility patterns is essential for appropriate empirical therapy. Objectives: To evaluate the clinical profile, microbiological spectrum, and antimicrobial susceptibility patterns of urinary tract infections in paediatric patients attending a tertiary care centre. Materials and Methods: This hospital-based observational study included paediatric patients aged 0–14 years with clinical suspicion of UTI. Urine samples were collected using standard aseptic techniques and processed by conventional culture methods. Bacterial isolates were identified, and antimicrobial susceptibility testing was performed using the Kirby–Bauer disc diffusion method as per CLSI guidelines. Results: Out of 90 urine samples analyzed, 32 (35.5%) showed significant bacterial growth. Escherichia coli was the most common uropathogen, followed by Klebsiella pneumoniae and Enterococcus species. High resistance was observed to ampicillin and cotrimoxazole, whereas nitrofurantoin and aminoglycosides demonstrated higher sensitivity rates. Conclusion: Paediatric UTIs are predominantly caused by Gram-negative organisms, with E. coli being the leading pathogen. Increasing antimicrobial resistance emphasizes the need for culture-guided therapy and regular surveillance of local resistance patterns to optimize treatment outcomes.