Antimicrobial resistance (AMR) is an increasing global concern, with Acinetobacter spp. being among the most common causes of difficult-to-treat hospital-acquired infections. Catheter-associated urinary tract infections (CAUTI) are common among hospitalized patients, and they worsen when caused by multidrug-resistant Acinetobacter spp. Such infections lead to extended sickness, increased death, and higher healthcare expenses. According to recent WHO and ICMR publications (2023-2024), carbapenem resistance in Acinetobacter is more than 70% in India, demonstrating the severity of the situation. The goal of this study was to determine the prevalence of MDR Acinetobacter spp. infections in CAUTI patients, examine their drug resistance patterns, and identify associated risk factors. The study comprised 250 CAUTI patients hospitalized to Sree Balaji Medical College and Hospital in Chennai between November 2024 and June 2025. Patient demographic and clinical information, as well as admission location and catheterization details, were obtained. To examine resistance profiles, isolates were selected and evaluated for antimicrobial susceptibility. Out of 250 CAUTI patients, 95 (38%) had urine cultures positive for multidrug-resistant Acinetobacter spp. Infections were most prevalent in the intensive care unit (50%), followed by medical wards (35%), and surgical wards (15%). Imipenem and meropenem showed the strongest resistance (80% and 78%, respectively), although colistin resistance was very low (10%). Prolonged catheterization (75%), ICU stay (60%), and poor hand hygiene compliance (50%), were the most significant risk factors for infection. MDR Acinetobacter spp. poses a severe difficulty in CAUTI treatment. Effective infection prevention strategies, antibiotic stewardship, and early detection are critical. Alternative medicines, such as phage therapy and combination regimens, should be investigated to lessen the load on healthcare systems.