Background <p>Urinary tract infections (UTIs) are among the most common infections in females, with many experiencing at least one episode in their lifetime. About 150&#xa0;million cases of UTIs occur each year. Lately, the prognosis of UTIs has been poor, largely due to a rise in antimicrobial resistance among common uropathogens. The present study was conducted to describe UTIs in female clients at Zomba Central Hospital in Malawi.</p> Methods <p>This was a retrospective cross-sectional study where 340 records of women suffering from UTIs were evaluated. Records were analysed for demographic characteristics, the causative agent of UTIs and their antimicrobial susceptibility profile. Data were cleaned and analysed in Excel 2016.</p> Results <p>The overall prevalence of UTIs was 48.53%, with age group 15–45 having a higher frequency (53.33%) than other age groups. The most frequently isolated bacteria were <i>Escherichia coli</i> (27.2%), <i>Staphylococcus species</i> (26.5%), <i>Enterobacter species</i> (19.2%), <i>Citrobacter freundii</i> (11.9%), <i>Proteus species</i> (6.0%), <i>Enterococcus species</i>, and <i>Serratia marcescens</i> (4.6%). Comparatively, meropenem and amikacin were effective against most pathogens showing average sensitivity rates of 51% and 56% respectively. Nevertheless, high levels of resistance to ampicillin (87%), ceftriaxone (77%) ciprofloxacin (70%), gentamicin (77%), and cefoxitin (64%) were observed.</p> Conclusion <p>UTIs remain a significant health concern among females at Zomba Central Hospital, particularly in the reproductive age group. The high prevalence of multidrug-resistant uropathogens, especially against commonly used antibiotics like ampicillin and ceftriaxone, underscores the urgent need for regular antimicrobial resistance surveillance and evidence-based antibiotic stewardship to guide effective treatment strategies.</p> Clinical trial number <p>Not applicable.</p>