BACKGROUND Urinary tract infection is the most common bacterial infection in post-menopausal women. Urine is a good culture medium for the growth of bacteria. This infection can lead to urinary sepsis if not diagnosed with proper clinical and bacteriological evolution. There is a need to study the various typical and atypical presentations of urinary tract infection and probe various microbiological agents causing urinary tract infection. METHODS This is a time bound observational hospital based prospective analytical study conducted in the Dept. of General Medicine, Down Town Hospital, Guwahati, Assam, between Jan 2017 to Dec 2017. 100 patients who showed growth on urine culture were included in the study. RESULTS 100 urine culture positive cases of postmenopausal females aged 45 years and above were included in the study. 76 patients were found to be having complicated UTI whereas 24 patients were having uncomplicated UTI. Fever (37%) is the most common presentation of the patients in UTI, overall as well as individually in uncomplicated UTI while burning urination (30%) is the most common clinical presentation among complicated UTIs followed by pain abdomen (23%). For complicated UTI, diabetes mellitus (46.2%) is most common risk factor. Gram negative organisms are the most common uropathogens as recorded in the study. CONCLUSIONS Present study revealed that clinical presentation is not conclusive but plays a minor role in establishing diagnosis in UTI. Uncomplicated UTI is high among younger females in postmenopausal age group. Complicated UTI is more common among older age group. Fever and burning of micturition are the most common symptoms; combination of symptoms is more predictive of UTI. Diabetes and urogenital instrumentation are the major risk factors for complicated UTI. E. coli is still the most widely prevalent organism causing UTI in the community, and increasing rates of resistant ESBL species are found.