Background:Urinary tract infection (UTI) is a leading cause of morbidity during pregnancy. The rising threat of antimicrobial resistance (AMR) amonguropathogens against extended-spectrum beta-lactams and carbapenems poses a serious treatment challenge. However, there is a limited data on ESBL- and carbapenemase-producing uropathogens among pregnant women in Bahir Dar, Northwest Ethiopia. Objective:To assess the extended-spectrum beta-lactamase and carbapenemase profile of uropathogens isolated from pregnant women in Bahir Dar, Northwest Ethiopia. Methods and materials: A facility-based cross-sectional study was conducted at Felege Hiwot Comprehensive Specialized Hospital (FHCSH) and Tibebe Gihon Specialized Teaching Hospital (TGSTH) in Bahir Dar, Northwest Ethiopia,from 9 February to 8 May 2026.From the 10mL of midstream urine sample obtained, 1 µL of it was inoculated into blood and MacConkey agar for bacterial identification. Antimicrobial sensitivity testing (AST) was performed using the Kirby-Bauer disc diffusion technique.ESBL and carbapenemaseproduction were detected using the combined disc diffusion method and modified carbapenem inactivation methods, respectively. Data were entered into SPSS version 26 for analysis. Logistic regression was done to identify factors associated with SBU and a p-value ≤ 0.05 was considered statistically significant. Results:From the total 260 pregnant women recruited, the proportion of significant bacteriuria (SBU) was 21.2% (55/260).The majority, 40 (72.7%), of the isolates were Gram-negative rods (GNRs), with uropathogenic E.coli (UPEC) as the predominant pathogen,31 (56.4%). From the total 40 GNRs, 92.5%, 60%, and 57% were found resistant to ampicillin, trimethoprim-sulfamethoxazole, and amoxicillin-clavulanic acid, respectively. On the reverse, 97.5% of GNR isolates were susceptible to meropenem, amikacin, and nitrofurantoin.MDR, ESBL, and carbapenemase production were observed in 58.2%, 16.2%, and 2.5% of isolates, respectively. ESBL and carbapenemase-producing isolates were found 100% MDR. Age (15-24 yrs.), third-trimester gestation, and a history of UTIs showed a statistically significant association withSBU. Conclusions: A high proportion of SBU was observed, mainly caused by GNRs with high MDR rates.The isolation of ESBL and carbapenemase-producing uropathogens was also a concern. This emphasizes challenges in treating UTIs and highlights the importance of screening for SBU among pregnant women,continuous surveillance of AMR, and rational use of antibiotics.