Objective: This study aimed to evaluate the clinical features, associated risk factors, microbiological spectrum, and antimicrobial susceptibility patterns of urinary tract infections (UTIs) among patients with diabetes mellitus (DM). It further explored the relationship between diabetic complications and the presence of bacteriuria. Method: A cross-sectional, descriptive study was conducted in the Department of General Medicine from January 2024 to October 2024. A total of 100 diabetic patients were enrolled based on defined inclusion and exclusion criteria. Clinical examination, urine culture, and laboratory investigations including fasting plasma glucose, HbA1c, and ultrasonography were performed. Midstream urine samples were cultured on MacConkey, blood, and chocolate agars. Isolated organisms were identified, and antibiotic sensitivity testing was done using the Kirby-Bauer disc diffusion method. Data were analyzed using SPSS v26, and statistical significance was considered at p < 0.05. Results: Out of 100 participants, 45% exhibited bacteriuria. Type II diabetes was more prevalent among those with bacteriuria. No statistically significant association was observed between bacteriuria and sex, age, or treatment type. However, poor glycemic control (HbA1c >10%) was more common in the bacteriuric group. The most frequently isolated pathogen was Escherichia coli (36%), followed by Pseudomonas (18%), Klebsiella (15%), Enterococcus (13%), Acinetobacter (9%), and Candida (9%). Carbapenems such as meropenem and imipenem showed the highest sensitivity. Bacteriuria was notably more frequent in patients with nephropathy, diabetic foot, and retinopathy. Conclusion: Diabetic patients, especially those with complications and poor glycemic control, are at a significantly higher risk for UTIs. E. coli remains the predominant uropathogen, and rising antimicrobial resistance underscores the need for regular microbiological surveillance and tailored antibiotic therapy.