Introduction: Healthcare-associated infections, often known as nosocomial infections (HAIs), pose serious risks to patient safety and global healthcare systems. These infections are associated with increased rates of morbidity and death as well as the growth of antibiotic-resistant bacteria. They are frequently associated with invasive procedures and use of medical devices. Nevertheless, there is a lack of standardized surveillance for HAIs, despite their widespread impact. This study aimed to examine the dynamics of nosocomial infections, including infection rates, surgical site infections, and antibiotic resistance, in a tertiary care hospital in Pakistan. Methodology: Data were collected retrospectively from January 2023 to December 2023 and covered the following topics: patient demographics, infection types and severity, surgical techniques, trends of antibiotic resistance, antibiotic stewardship initiatives, and environmental evaluations. Results: The study's findings demonstrated a sizable patient population, with urinary tract infections ranking highest among several types of nosocomial infections. Seasonal differences were noted, with pneumonia predominating in winter and gastrointestinal and skin infections being more common in summer. Different infection types have different mortality rates, with pneumonia having the highest death rate. Conclusion: This study highlights the prevalence of nosocomial infections, their seasonal fluctuations, and the critical role of infection prevention and control techniques in reducing their impact on patient outcomes and healthcare systems.