Antibiotic resistance in aquatic bacteria is a growing concern with significant implications for public health and ecological systems. This review article aims to provide a comprehensive overview of the current understanding of antibiotic resistance in aquatic bacteria, focusing on the sources, pathways, and consequences of resistance development and dissemination. We explore the various sources contributing to the presence of antibiotics in aquatic environments, including wastewater discharge from human and animal sources, agricultural practices, and pharmaceutical manufacturing effluents. Additionally, we discuss the pathways through which antibiotic resistance spreads in aquatic ecosystems, including horizontal gene transfer and the persistence of antibiotics in sediments and biofilms. We highlight the role of aquatic organisms as reservoirs and vectors of resistance dissemination. Furthermore, the implications of antibiotic resistance in aquatic bacteria for public health and ecological systems are examined, emphasizing the need for effective management and prevention strategies. Finally, we discuss future perspectives and research directions, including the development of alternative treatment options, rapid diagnostic tools, advanced technologies, interdisciplinary collaboration, and global cooperation. This review underscores the urgency of addressing antibiotic resistance in aquatic bacteria and provides insights to guide future research and interventions aimed at mitigating the risks associated with this global challenge