Abstract Background: Septicemia is a condition in which the bacteria multiply and release toxin in to the bloodstream. Blood stream infection (BSI) is one of the most important causes of morbidity and mortality of patients. Bacterial profile and their antibiotic resistance varies from place to place. Moreover, drug resistant bacterial pathogens become challenging throughout the world. Objective: The aim of this study was to determine bacterial and antimicrobial susceptibility profile of blood culture isolates among septicemia suspected patients admitted at Felege Hiwot Referal Hospital, Northwest Ethiopia. Methods: A hospital based crosssectional study was conducted among patients suspected to septicemia admitted at Felege Hiwot Referral Hospital from April 2018 to July 2018. A total of 341 patients were included in the study. Blood samples were collected inoculated on to Trypton soya broth then incubated at 37 °C. After 24 hours incubation sub culture was done in to Blood agar plate, Chocolate agar plate and MacConkey agar plate. Antimicrobial susceptibility testing was done using Kirby Bauer disk diffusion method. Finally, data was entered and analyzed using SPSS version 23.Binary and multivariate logistic regressions were used to identify the possible associated factors and p value less than 0.05 was considered as statistically significant. Results: Out of 341 participants, 190 (55.7%) were male. The median age of study participants was 15 year. Of the total participants, 91 (26.7%) showed bacterial growth. Gram positive bacteria constituted 44 (48.4%). S. aureus 33 (36.3%), K. pneumoniae 18 (19.8%) and CoNS 9 (9.6%) were the common isolates in this study. Antimicrobial resistance for Gram positives ranges from 13.6-61.9 %. Gram negative bacteria antibiotic resistance ranges from 21.2-100%. The overall multi drug resistance was 73.6%. Indwelling medical device was associated with blood stream infection (p=0.01). Conclusion:The prevalence of bacterial isolates in blood stream infections is still high. S. aureus and K. pneumoniae were major isolates. In addition, the emergence of MDR bacteria for commonly used antibiotics was high. The causative microorganisms of blood stream infection and their antibiotic sensitivities differ by hospital. Therefore, continuous evaluation of bacterial isolates and drug resistance profile of blood stream infections in the hospital should be done. Key words: BSI, Bacterial profile, Antimicrobial susceptibility profile, admitted patients