BACKGROUND: Infections caused by multidrug resistant gram negative bacteria are often corresponded with increased comorbidities, prolonged hospitalization and mortality. These bacteria not only pose a serious threat to global public health but also create a burden to health care systems. The present study was aimed to identify the incidence of Multi drug resistance patterns among gram negative bacteria in hospitalized patients and the economic impact in their treatment. We have also studied the sensitivity and resistance patterns of the isolated gram negative organisms. METHODS: Prospective study was conducted on 165 patients. Relevant data pertaining to demographics characteristics, comorbid conditions, length of stay and costs of antibiotics was taken from the patients. Blood and other samples like swab, sputum, urine, CSF etc were also sent for the culture sensitivity testing. Antimicrobial susceptibility testing was carried out using the Kirby bauer disc diffusion method. RESULTS : The most common multi drug resistant Gram negative bacteria were E.coli (33.94% )and Klebsiella pneumoniae(12.12%) The multidrug resistance patterns show that E.coli is most resistant to Tetracycline and Amoxyclav , Klebsiella is highly resistant to Ampicillin, Ertapenem & Gentamicin. The economic burden was more in Multidrug resistant cases when compared to sensitive cases. CONCLUSION: There is an increase in multidrug resistance patterns especially in E.coli & Klebsiella pneumonia with a significant increase in costs in MDR cases, due to change in their therapy to a more sensitive antibiotic.