Streptococcus pneumoniae (S. pneumoniae), also known as pneumococcus, is found in the upper respiratory tract of 5-70% of healthy people. It causes otitis media, pneumonia and invasive pneumococcal diseases (IPD). The group with the highest risk for pneumococcal diseases are children, elderly people and people with chronic systemic illnesses. The identification of these serotypes is crucial to monitor the prevalent serotypes, to track resistance patterns, and to evaluate the efficacy of treatment and vaccination. Our aim was to determine antibiotic resistance in S. pneumoniae, identify the most common serotypes, determine the association between highly resistant strains and most common serotypes, and select an effective vaccine against the predominant serotypes in the Kingdom of Bahrain. One hundred isolates were included in the study. Antimicrobial susceptibility was determined by agar dilution and serotypes were determined by the Quellung reaction. Antimicrobial resistance rates were highest for penicillin in children ≤ 5 years old (34%) and elderly patients (29%). For the serotypes distribution of S. pneumoniae, the predominant serotypes were 19, 6, 23, 3 and 14 in the different age groups. The predominant serotypes that showed resistance to three antimicrobial agents were 19, 6, 23 and 14. The increasing pneumococcal resistance to penicillin, erythromycin, and tetracycline indicates the need for preventive measures, antibiotics use monitoring and stewarding. In light of the expanding prevalence of S. pneumoniae resistant to multiple antimicrobial agents, the need for an effective pneumococcal vaccine has become very important.