The objective of this study was to investigate the trend of antimicrobial resistance among gram negative bacteria isolated from patients of Elmonira pediatric teaching hospital. This was a one-year retrospective study. One hundred and eighty episodes of nosocomial bloodstream, urinary and respiratory tracts infection were reviewed during the study. The predominant isolate was klebsiella spp. (47.22%) followed by pseudomonas spp. (14.44%), E. coli (13.33%) and Enterobacter spp. (13.33%). The most active drug was imipenem. The highest resistance was to ampicillin. More than 75% of klebsiella spp and E.coli were resistant to cefotaxime.