Polymyxin' E' (Colistin) is considered the last resort therapy against Multidrug resistance (MDR) bacteria, mainly Klebsiella peumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Escherichia coli and play a critical role in causing life-threatening infection, and their prevalence is increasing as a big concern globally. Apart from immunological adaptation, chromosomal mutations and plasmid-mediated genes are mostly associated with this resistance at the molecular level. Therefore, the current review extensively focused on Colistin as a drug in 21st-century antibiotics, the activities spectrum with diverse resistance mechanisms of bacteria against Colistin, and emerging approaches of Colistin from discovery to tackling MDR. In the study, we got to know about the challenges and new developments with old weapons like phage therapy as well as new approaches like Phage display and drug repurposing, in addition to the chromosomal and plasmid-mediated genes that play a role in antimicrobial resistance (AMR). The present study would provide insight into the prognostic aspect of combating MDR.