Understanding antibiotic resistance and control measure is a challenge because it causes dissemination of multidrug resistance bacteria, and it causes high morbidity and mortality. Bacteria expressing extended spectrum beta lactamases (ESBL) have been recently reported globally at an alarming level and these issues exist in Middle East and Iraq. Bacteria bearing beta lactam resistance genes shows multi-drug resistance and it cause delay in treatment. The huge number of studies has been carried out to indicate the causes of drug resistances and the outcome of this problem in clinical fields. Therefore, this study is about to reviewing different causes and aspects of drug resistances such as: causes of drug resistance, antibiotic resistance mechanisms, antibiotic resistance reversibility, and different types of beta lactamase resistance genes, Resistance Genes (ESBL) in Middle East, and Resistance Genes (ESBL) in Iraq. The review highlighted all research showing the existence of different types of ESBL in humans, animals and environments in different places of Middle East and Iraq. Bacteria bearing β-lactamases resistance genes have been spread in all parts of Middle East which is public health threating; therefore, it's important to limit Antibiotic use by people. Further research is required in the studied area to understand the reason of antibiotic resistance and an attempt to find new antibiotic is very necessary to save future humans life.