A clinico-laboratory investigation of multidrug resistant (MDR) characteristics of extended spectrum βlactamase (ESBL) producing Escherichia coli pathotypes from some hospitals in Bauchi metropolis, Nigeria, was carried out. A total of 198 E. coli isolates were recovered from different patients' age group (0 to above 70 years), comprising of 134 males and 85 females, as both outpatient (126) and in-patient (93). The antimicrobial susceptibility tests show a high multidrug resistance among Ampicillin (97.0%), Amoxycillin (96.0%), the newer generation Cephalosporins like Cefuroxime (81.3%), Cefotaxime (85.4%) and Ceftazidime (60.6%). The isolates were sensitive to Ceftriaxone (62.1%), Amikacin (71.7%) and Imipenem (80.8%). Out of the multidrug resistant isolates, 163 were ESBL producers, with frequency of (26.9%) found within age group (31 to 40 years), mostly in males (59.1%) and outpatients (51.5%). Fifty four (27.3%) of the isolates were recovered from stool specimens with MDR and ESBL prevalence of (27.1%) and (26.9%) respectively. Based on clinical diagnosis, prevalence of MDR (29.5%) and ESBL production (28.2%) was found among cases of Urinary tract infections (UTIs), followed by Gastroenteritis (25.3%) and (25.8) respectively. These results indicate a strong association between multidrug resistance and ESBL production in E. coli pathotypes. The Amikacin and Imipenem sensitivity in this study advocates the usage of the carbapenem as the therapeutic alternative in the event of the increasing resistance rates observed with conventional beta-lactam antibiotics.