Background: The emergence of Multi drug resistant Pseudomonas aeruginosa (MDRPA) among intensive care unit (ICU) patients is increasingly recognized as a public health threat worldwide. Objective: This work aimed to study the occurrence of MDRPA among critically ill patients in a health care setting in Alexandria. Methods: During a 12 months period, different clinical samples (sputum, endotracheal aspirates, blood, urine, and pus) obtained from ICU patients were tested for the isolation and identification of Pseudomonas aeruginosa (P. aeruginosa) strains; that were screened for their antimicrobial susceptibility patterns using single disc diffusion method. Identified MDRPA strains were further tested for their susceptibility to polymyxin E (colistin), polymyxin B, and tigecycline. Polymerase chain reaction (PCR) assay was performed to detect VIM and IMP MBL genes. Results: Of the 105 P. aeruginosa strains isolated from various clinical samples, 20 (19%) were found to be MDRPA, of which 16 (80%) were sensitive to each of colistin and polymyxin B, while only 5 (25%) strains were sensitive to tigecycline. PCR assay revealed that 9 (45%) strains possessed VIM MBL gene and none (0%) harbored IMP MBL gene. Conclusion: The occurrence of MDRPA strains among critically ill patients in this study was noticeable; with colistin and polymyxin B being effective upon the majority of identified MDRPA strains, and VIM MBL gene was found to be significantly harbored.