Background and Aim: The spread of ESBL in Escherichia coli isolates has led to increased antibiotic resistance and mortality. Therefore, the present study was performed to investigate the susceptibility and antibiotic resistance patterns of ESBL-producing E. coli strains isolated from patients referred to Zanjan hospitals. Materials and Methods: In this descriptive-analytical study, 260 urinary tract infection specimens were identified in Zanjan hospitals in 2019, 100 E. coli isolates were identified by standard bacteriological methods. Antibiotic susceptibility of the isolates was determined by disk diffusion method and ESBL-producing isolates were identified by combined disk method. Results: The most resistant to ampicillin (72%) and tetracycline (50%) were the most sensitive to amikacin (94%) and nitrofurantoin (90%), respectively. A total of 41 samples were identified as the final ESBL producer. Conclusion: The results indicate a relatively high prevalence of ESBL in E. coli isolates in Zanjan. Given the high prevalence rate, it is necessary to monitor the resistance pattern of gram negative isolates in Zanjan. Given the high percentage of resistance to E. coli isolates to antibiotics and to reduce the spread of resistance genes, sensitivity testing is recommended to select more effective antibiotics even for outpatient isolates.