Wastewater is a major collector for antibiotic resistant and pathogenic microorganisms posing high risk on public health and environmental. Even efficient secondary sewage treatment does not ensure appropriate removal of pathogens especially MDR E. coli. This study aimed to shed light on the prevalence and antimicrobial resistance of E. coli in raw wastewater, treated water, sludge, and forest soil irrigated with treated water from the Serapium wastewater treatment plant in Ismailia, Egypt. Samples were collected monthly during the period February 2018 to January 2019 from different wastewater treatment stages as well as sludge, reclaimed soil and affected water sources. E. coli isolated on HiChrome E. coli agar and verified by indole reagent system. Kirby-Bauer disk diffusion method was used for antimicrobial susceptibility testing for 19 different antibiotics. E. coli mean count ranged between 4.7×104 and 6.3×105 MPN/100mL in the influent and 2.1×102 and 6.3×103 MPN/100mL for effluent indicating high bacterial load in the effluent. Antimicrobial susceptibility rate for the selected 337 E. coli strains was highest for ampicillin (29.2%), tetracycline (22.5%), and ciprofloxacin (16.3%) while lower resistance for ertapenem (2.4%), imepenim (2.3%), and meropenim (2.3%,) and 4.4% azithromycin. ESBL producing E. coli represents 20.67% of the isolates. Notwithstanding, upwards of 103 MPN/100mL E. coli with high MAR index (>0.2) has reached the receiving ecosystem and thus the processes of sewage treatment contribute to the spread of antibiotic resistant bacteria into the environment.