Abstract: This study evaluated urine cultures and the antimicrobial resistance patterns of E. coli detected from urine culture. This study was performed on 520 hospitalized urine samples including 401 females and 119 males during one year (2008-2009) in Khorramabad City (West Iran). The urine cultures and antibiotic sensitivity tests based on Kirby-Bauer method were analyzed according to the antibiotic resistance pattern of each bacterium. A total of 520 urine samples were analyzed out of which 129 (24.8%) showed significant growth and 115 (89.1%) were gram-negative bacteria. The most frequently detected gram-negative bacterium was E. coli with 85 cases (73.9%). Urinary Tract Infection (UTI) was seen in 79.1% of the females as compared to 20.9% of the males (p<000.1). The most resistance rates for E. coli detected from urine culture were to ampicillin with 98.4% and to amoxicillin with 83.7%, respectively. The most antibiotic sensitivity rates were to amikacin with 93.3%, ciprofloxacin with 91.5%, nitrofurantoin with 89.8% and to nalidixic acid with (78.7%), respectively. Present findings demonstrated the significance of resistance increase of E. coli detected from urine culture to various groups of antibiotic drugs, caused by the irregular use of antibiotics.