Background: Urinary tract infections (UTIs) are one of the most common bacterial infections which affect more than 150 million individuals each year worldwide. Objective: this study was conducted to assess the risk factors associated with urinary tract infections (UTIs) caused by resistant Escherichia coli. Methodology Four hundred and thirty urine samples were collected from outpatients who had urinary tract symptoms, ages ranging from 10 to 75 years in Beni-Suef Egypt, during a period extended from January 2021 to the end January 2022 and processed by standard microbiological methods. Results A total of 430 patients were included in this study, 210 (48.82%) uncomplicated and 220 (51.15%) complicated UTIs. Of 430 UTIs patients 287(66.8%) were females (77(36.6%) were complicated and 210(100%) uncomplicated), while 143 male UTIs patients were classified as complicated (65%). The prevalence of pathogenic microbes reveals bacterial species predominate in UTIs with 376 (87.42), E. coli high-frequency bacterial strains 85 (19.9), followed by Klebsiella sp. 70 (16.3), Pseudomonas aeruginosa 58 (13.5) and Enterococcus sp. 58 (13.5). Proteus mirabilis 46(10.9). Among 85 E coli isolates 46 from complicated and 39 isolates from uncomplicated UTIs patients showed the highest resistance to piperacillin/tazobactam 35(41.2%), sulfamethoxazole /trimethoprim 35 (41.2%), amoxicillin-clavulanic acid 34 (40%) and cefepime 34 (40%) and the least resistant antibiotics in the present study were colistin (3.5%), imipenem (5%), quinolones (5%) and nitrofurantoin (5%). Conclusion, nitrofurantoin, and quinoline remain still the best choice for treating complicated and uncomplicated UTI. Risk increases with the number of patients hospitalizations