Background: Urinary tract infection (UTI) has become the most frequent bacterial infections worldwide. It is well established that Escherichia coli is the predominant cause of UTI. The aim of our study was to evaluate the rates of resistance to fluroquinolone and third generation cephalosporin among the patients with UTI due to E.Coli and to assess the potential correlation between both trends. Methods: The study was a cross sectional observational study conducted at the Department of Pharmacology and Therapeutics in collaboration with Department of Microbiology of Sylhet Women’s Medical College and Hospital from 1st July 2019 to 30th June 2020. Results: A total of 246 urine samples were collected from patients with UTI followed by isolation and identification of E.coli strains. Antibiotic sensitivity and resistance analysis was performed by the disc diffusion method employing multiple antibiotic discs. The sensitivity was monitored by zone of inhibition around the disc. Overall rates of resistance to fluroquinolone and third generation cephalosporin were 70.31% and 65.10% respectively. The rates of co-resistance to both fluroquinolone and third generation cephalosporin was 53.13%. Conclusion: Our study suggests that fluroquinolone should be reserved and third generation cephalosporin should be used with caution among patients with E.coli.