Background: Anti-microbial resistance (AMR) due to the over use of the reserved antibiotics like ceftriaxone is one of the threatening global issues of public health and many patients suffer due to harms arising from AMR because the infections caused by viruses, bacteria, fungi, protozoa and helminthes are no longer susceptible to the commonly available antibiotics. Objective: To evaluate the utilization pattern of ceftriaxone at Medical Ward in Bedele General Hospital, Bedele, South West Oromia, Ethiopia. Methodology: Patients' medical record cards (PMRCs) from the medical ward at Bedele General Hospital who took ceftriaxone between July 1 and December 30 of 2021 were the subject of a hospital-based retrospective cross-sectional study design and the selection of the medical record cards was done using a systemic random sample technique. Utilizing current Ethiopia's Standard Treatment Guideline for General Hospital and Drug Use Evaluation Criteria, the appropriateness of the ceftriaxone usage was assessed. Results: A total of 212 patients’ medical records were reviewed and the most frequent age group was adults in the range of 18-65 (80.5%) and the use of ceftriaxone was inappropriate in 185 cases (47.1%). Ceftriaxone was mainly used for the treatment of pneumonia condition (46.2%), regarding ceftriaxone dosage in our study, the majority of patients received 2 g/day (85.4%) and the mean duration of ceftriaxone therapy in our study was 11.47 days, with a range of 2-7 days (49.7%). Maintenance fluids were the most commonly co-administered medications with a frequency of 32.9%. Conclusions: Prescribers should follow the national standard treatment guideline in order to increase rational use of ceftriaxone and stop the emergence of resistance. The hospital may choose to implement antimicrobial control systems and short-term training for health care professional in order to adhere the treatment guideline is our recommendation.