Pseudomonas aeruginosa was the most frightening pathogen that emergence in health facilities with increasing antibiotic resistance. Nanoparticles have reported as non-antibiotic therapeutic agents, that are highly effective in the treatment of P. aeruginosa infections. Combination therapy of nanoparticles and antibiotics considered an alternative therapeutic approach for restoring antibiotic activity. To achieve that goal, we used the synthetic silver nanoparticles in a combined form with ciprofloxacin against MDR P. aeruginosa. Fifty bacterial isolates that collected from different infection sites were confirmed as P. aeruginosa by detection of algD gene and Exotoxin A genes. Antibiotic sensitivity of P. aeruginosa strains was assessed by single disk-diffusion method. The most prevelant phenotype among P. aeruginosa were recorded. The synthetic nanoparticles AgNPs and ZnONPs were tested against all P. aeruginosa strains. minimum inhibitory conc (MIC) of ciprofloxacin and AgNPS was determined using microdilution method for 24 selected P. aeruginosa strains and in the range from 160-1280, 6-12mg/l, respectively. In vitro, the synergistic activity of ciprofloxacin and AgNPs was achieved in all combinations. Our finding approved that combination therapy depend on using nanoparticles considered a promising tool used to restore the activity of antibiotics.