Abstract : Infections associated with Multidrug-resistant (MDR) Pseudomonas aeruginosa are a cause of substantial morbidity and mortality in Intensive Care Units of Tertiary Care centers. Therefore, it is of paramount importance to evaluate the prevalence and the antibiotic sensitivity pattern to overcome the associated challenges in healthcare settings. It is a retrospective observational study carried out at 3 ICUs of Medicine and Surgery departments. Data consists of demographic details and the results of culture and sensitivity of the clinical specimens of patients admitted in the ICU that were sent to the Department of Microbiology, Central lab during the period of October 2024 – March 2024. The data was retrieved from hospital documentation and was analyzed using SPSS 26 software system. Statistics were applied to find percentages and frequencies. During the study period, a total of 350 samples were received from the patients admitted in the ICU and Pseudomonas aeruginosa was isolated in 33 (9.42%) samples out of which the prevalence of Multi Drug Resistant strains was 17 (51.5%). The overall Prevalence of MDR Pseudomonas aeruginosa isolates in ICU was found to be 4.85%. The mean age of our study population was 55.28±17.05 years. The rate of isolation of Pseudomonas aeruginosa isolates was more in urine samples i.e., 17 (52%). Aztreonam and Colistin showed highest sensitivity i.e., 96.9%, and least resistance was seen to Piperacillin tazobactam i.e., 21.2%. Piperacillin-Tazobactam, which is the first line drug, can still be used for treating Pseudomonas infections in the ICU patients. Increasing resistance in Pseudomonas aeruginosa isolates is an alarming sign. Therefore, emphasis should be given to early and rapid detection, strict antibiotic policy and continuous monitoring of the drug-resistant strains. Aztreonam and Colistin can be reserved for the infections showing resistance to both Piperacillin-tazobactam and Carbapenems.