BACKGROUND: Urinary tract infections are bacterial infections, affecting people of all ages and genders, The clinical manifestation of a UTI can vary based on the site of infection. Symptoms of Lower UTIs(cystitis) include lower abdominal pain, burning micturition, dysuria, pyuria, and upper UTI (pyelonephritis) including fever, chills, and rigors. Early diagnosis with urine routine and urine culture with appropriate antibiotics shows better treatment outcomes. Asymptomatic bacteriuria patients not be treated with antibiotics which increases antimicrobial resistance according to IDSA guidelines, so framing and following antibiogram and treating according to guidelines is important. METHODS: The prospective observational study was conducted in tertiary care hospital in Chennai. A total of 80 patients were recruited in the study, following a six-month observational study, Data includes baseline demographic details, patient clinical profile, microbiological profile, and treatment outcomes. The obtained results were recorded and statistically evaluated using SPSS software version 26 for Windows. RESULTS: In our study, the prevalence of UTI is more common in females than males, The symptoms were present in 71 patients. Urine routines were sent to all the patients. Urine cultures were sent to 49 patients. The number of patients diagnosed with lower UTI is 40, upper UTI is 31, and asymptomatic bacteriuria is 9. E.coli was the most common pathogen reported (20%). Patients treated with definitive therapy has lesser hospital stay and better outcome when compared with the empirical therapy. CONCLUSION: Our study concludes that treating patients with empirical therapy shows a gradual increase in their length of stay in the hospital which encourages the emergence of bacterial resistance and results in a deterioration in a patient’s outcome. According to IDSA guidelines treating asymptomatic bacteriuria patients have a high chance of resistance. Therefore, following hospital antibiogram policy and taking urine cultures for symptomatic patients and treating patients definitive would result in good treatment outcome.