Antimicrobial resistance (AMR) is a growing global health concern, driven by complex interactions across clinical, environmental, and socioeconomic domains. While much research has focused on AMR prevalence in urban healthcare settings, rural environments—often lacking structured surveillance—are emerging as critical reservoirs of resistance genes. This paper presents a comparative study of AMR patterns in urban versus rural areas, synthesizing recent research on clinical isolates, environmental samples, livestock-associated resistance, and socio-behavioral drivers. The analysis reveals higher detection of extended-spectrum beta-lactamase (ESBL) and carbapenem-resistant organisms in urban hospitals, while rural regions show elevated levels of environmental and zoonotic transmission of resistant bacteria, often linked to agricultural runoff, poor waste management, and informal antibiotic use. Socioeconomic disparities further exacerbate resistance by varying hygiene, healthcare access, and awareness. The study underscores the importance of adopting a One Health approach and improving AMR surveillance and stewardship strategies tailored to the specific risks of both urban and rural contexts.