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Pseudomonas aeruginosa is a leading cause of nosocomial infections; it is highly resistant to many antibiotics by several different mechanisms. The main purpose of this study was to determine the dissemination of (MDR) Sader Medical City in Al- Najaf province .A total of 200 clinical and hospital environment samples, 32 isolates were identified as P. aeruginosa by the Oxidase test and confirmed by VITEK-2 compact system. Susceptibility testing was done using the VITEK-2 compact system. The isolates were examined for the presence of extended spectrum beta-lactamases (ESBLs), (OXA, CTX- M, TEM, SHV ), carbapenemases class B (IMP, VIM), and class A (KPC), in addition, aminoglycosides resistant genes(aac(3')-I aac(6')-Ib, aac(6')-I) by PCR. 8 isolates exhibited PDR, 2 isolates exhibited XDR and 3 displayed MDR. The majority (20/32) of the P. aeruginosa were positive for blaOXA. In addition, 10 isolates harbored blaCTX-M and 7 isolates were positive for the carbapenemase gene blavim.The blaIMP and blaKPC were not detected. All bacteria harboring blaVIM gene has a PDR resistant phenotype. Fifteen isolates contained at least 1 aminoglycosides resistance gene.