Background: Urinary tract infection (UTI) is one of the most common bacterial infections in women; about 50% of women get during their life time. Moreover, it is a common health problem in patients with gynecological pathologies, which increases the chance of acquiring infection. The aim of this study was to determine the bacterial profile that causes UTI and their antibiotic susceptibility pattern among admitted gynecological cases. Methods: A cross-sectional study was conducted in south west Ethiopia region. A total of 386 patients admitted with gynecological cases were included and structured questionnaire was used to collect socio-demographic and risk factor-related data. About 10ml freshly voided midstream and catheterized urine specimens were collected using sterile containers. Identification of isolate was done using culture characteristics, gram staining, and a series of biochemical tests. The data obtained were entered into EpiData Version 3.1 and analyzed using SPSS Version 25. A P-value of less than 0.05 was used as a level of significance. Results: In this study, the overall prevalence of UTI was 25.4%. E. coli was the most frequently isolated bacteria, which accounted for 38(37.6%), followed by Klebsiella species 22(21.8%), CONS 14(13.9%), S. aureus 10(9.9%), Enterobacter species 6(5.9%), Citrobacter species 5(4.9%), P. mirabilis 4 (4%), and P. aeroginosa 2(2%). Histories of UTI (AOR = 1.977, 95% CI: 1.06, 3.68, P = 0.032) and catheterization (AOR = 2.38, 95% CI: 1.28, 4.45, P = 0.006) were found to be statistically associated with significant bacteriuria. Gram-negative isolates showed a high level of resistance, 88.3% for ampicillin and 66.2% for tetracycline, and a relatively low level of resistance against ceftazidime, 22.1%, and meropenem, 3.9%. Gram-positive uropathogens showed a high level of resistance to penicillin, 91.6%, whereas all isolates were sensitive 100.0% to nitrofurantoin. Furthermore, 80 (79.2%) of the isolates had multidrug resistance, and 16 (26.7%) of both E. coli and Klebsiella spp. produced Extended Spectrum β-lactamase. Conclusion: In this study, a high prevalence of uropathogenic bacteria and multidrug resistance for commonly prescribed drugs were observed with a significant number of Extended Spectrum β-lactamase producers.