Introduction: Pseudomonas aeruginosa is a common bacterial pathogen with wide spread distribution in health care settings. It is a multidrug resistant pathogen recognized for its ubiquity and intrinsically advanced antibiotic resistance mechanisms. This study aims to find out the isolation rate and to determine antimicrobial susceptibility patterns, and level of multidrug resistance from nosocomial and environmental isolates of P. aeruginosa. Methods: A cross-sectional study was carried out over a 6-months period from September 2022 to February 2023 and a total of 217 samples were enrolled which included 130 different clinical specimens from patients with nosocomial infections and 87 samples of hospital environment at different departments in four hospitals in Aden governorate, Yemen. The isolates were identified by biochemical tests as well as the susceptibility patterns which were tested by 22 types of antibiotics. All data were analyzed using SPSS statistics version 22 with a significance level of P<0.05. Results: The P. aeruginosa were isolated from 23.1% of clinical specimens and 32.2% from environmental samples. The statistical analysis showed no statistically significant difference between clinical and environmental samples in prevalence (P˃0.05). The most effective antibiotic against clinical isolates was Pipracillin/tazobactam with only 6.7% resistance value. In contrast, the most effective antibiotic against environmental strains was ciprofloxacin without any resistance value. The resistance to other antibiotics was found to be high or completely resistant. Ninety percent of clinical P. aeruginosa isolates and 96.4% of environmental isolates were multidrug resistant.