Urinary tract infections (UTI) are common worldwide and affect all sexes and age groups. An estimated 20% or more of the female population suffers from some form of UTIs in their lifetime. Although antibiotics are the first choice of treatment for many urinary tract infections, antibiotic-resistant strains of bacterial species commonly associated with UTIs, are increasing worldwide. The purpose of this study was to determine the pathogen antimicrobial sensitivity trends of bacterial pathogens associated with UTIs. A retrospective study was carried out on bacteria isolated from the urine of patients at the BUTH laboratory between January 2006 and December 2010. A total of 1611 pathogens have been found. The most commonly isolated bacteria were Escherichia coli (876 strains), Klebsiella Species (190 strains), Coagulase negative Staphylococcus (114 strains), Streptococcus species (97 strains), Proteus species (90 strains) and staphylococcus aureus (86 strains). Most of isolates were resistant to aminopenicillins (ampicillin and amoxicillin) and to trimethoprim-sulfamethoxazole (TMP-SMZ). Strains were rarely resistant to more expensive antibiotics (imipenem and cefotaxime). The most effective antibiotic to almost all isolates was imipenem, which is not commonly used in treatment of UTIs in Rwanda. The rate of amoxicillin and trimethoprimsulfamethoxazole resistance to Enterobacteriaceae implies that another antibiotic should be used for empirical treatment and that there is a need for new generic drugs in Rwanda. Imipenem could be included as a reasonable alternative for the therapy of UTIs in Rwanda.