Antimicrobial resistance (AMR) poses a critical global public health threat, with Pseudomonas aeruginosa emerging as a formidable MDR pathogen. This systematic review examines the prevalence and patterns of antibiotic resistance in P. aeruginosa within Bangladesh from 2006 to 2024. A comprehensive literature search was conducted across databases including PubMed, Google Scholar, Science.gov, and ResearchGate, yielding 12 studies that met the inclusion criteria. Most of these studies were conducted in Dhaka between 2021 and 2024, utilizing the disk diffusion method following CLSI guidelines. Findings indicate alarmingly high resistance rates to several commonly used antibiotics, including vancomycin (100%), cefoxitin (100%), amoxicillin (96.37%), erythromycin (95.48%), and ampicillin (91.43%). Notably, lower resistance was observed for colistin (19.05%) and piperacillin/tazobactam (28.70%), suggesting these antibiotics remain viable treatment options. The resistance mechanisms of P. aeruginosa, such as low outer membrane permeability, active efflux pumps, and biofilm formation, contribute to its resilience against antimicrobial agents. Comparative analysis reveals that resistance rates in Bangladesh are significantly higher than those reported in other regions, exacerbating the challenge of managing infections effectively. This review recommends implementing nationwide surveillance systems, stringent antimicrobial stewardship programs, and enhanced infection control measures to address the escalating AMR crisis. Furthermore, there is an urgent need for research into novel therapeutic strategies and the development of new antibiotics. By synthesizing current evidence, this study aims to inform policymakers, guide clinical practices, and support public health initiatives to mitigate the impact of antibiotic-resistant P. aeruginosa in Bangladesh.