Introduction: Urinary tract infections (UTIs) are the most common bacterial infection worldwide. The emergence of extended-spectrum β-lactamase (ESBLs)- and carbapenemases producing Enterobacterales raised dramatically in low-income countries including Pakistan. This study aimed to determine the antimicrobial resistance patterns, and co-production of blaCTX-M and blaNDM among carbapenem resistant Enterobacterial (CRE) species from UTI patients. Methodology: One-year cross-sectional study was conducted at the Department of Microbiology, University of Karachi in collaboration with Jinnah Postgraduate Medical Center (JPMC), Karachi. A total of 111 CRE isolates were isolated from hospitalized and outdoor UTI patients. Identification was performed by biochemical tests and API 20E, antimicrobial susceptibility testing, ESBL and carbapenemases detection were carried out following CLSI guidelines. Genotypic identification was performed by PCR. Results: Predominate isolate was E. coli (74%) followed by K. pneumoniae (16%). High frequency (85.9%) of isolates were recovered from hospitalized patients with highest prevalence of females (64.9%). Higher resistance was observed against cephalosporins, carbapenems, fluoroquinolones (100%). Phenotypically (39.6%) ESBLs producers were (98.9%) PCR positive for ESBL genes. Among ESBLs blaCTX-M-1 predominated either alone or in combination with blaSHV and blaTEM 83 (74.8%). CRE (86.5%) were positive for carbapenemases genes, blaNDM (79.3%) was the most common gene. Co-production both blaCTX-M-1 and blaNDM was identified in (63.5%) of carbapenemase-producing isolates. Conclusion: High prevalence of dual resistance genes and complete resistance of most of the antibiotics highlights the urgent need for surveillance, antimicrobial stewardship, and infection control strategies. Key words: Urinary tract infections (UTIs), Carbapenem resistant Enterobacterial (CRE), extended-spectrum β-lactamase (ESBLs)