Objective: To assess the epidemiology of antimicrobial resistance among community-residing persons with spinal cord injury (SCI). Design: Retrospective analysis of existing data. Setting: Data were obtained from persons with SCI attending clinic for annual examinations. Participants: Two hundred eighty-seven SCI outpatients. Intervention: None. Main Outcome Measure: Occurrence of bacteriuria with gram-negative organisms demonstrating resistance to antimicrobial agents in 2 or more classes. Results: There were 706 gram-negative isolates from 444 urine specimens. Resistance to drugs in 2 or more classes occurred in 33% of bacterial isolates, but did not significantly increase in frequency among those injured for longer periods or more severely. Significantly higher rates of multidrug-resistant bacteria occurred in specimens from males, younger age group (≤ 45yrs), and persons with indwelling and condom catheters. Conclusions: Antimicrobial resistance in outpatients with SCI is common and is related to widespread use of specific drugs, type of bladder management, and other host factors. (C) 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.