Background: UTI in SAM prevalence rates range from 6% to 37% in developing countries. The most common bacterial isolates are Gram negative organisms. Due to increase in the magnitude of antibiotic resistance, there is a need to routinely investigate specific pathogens causing UTI and use effective antibiotics. Methodology: It was a hospital based prospective study. All children who fulfilled WHO criteria for SAM, admitted at KIMS were included. Fresh urine samples were collected at admission and sent for urine microscopy and culture sensitivity. Urine dipstick for nitrites and leucocyte esterase was also done