Two hundred and thirty-six E. coli isolates n=236 were collected. Antibiotic susceptibility and ESBL production were studied by disc diffusion and DDST (double disk synergy tests) according to Clinical Laboratory Standards Institute guidelines (CLSI) and EUCAST for ESBL. 75 (32%)of total isolates demonstrated MDR (multi drug resistance),62 of resistant bacteria (26% of total) were determined as ESBL producers. In conclusion, we recommend adding this standard, cheap ESBL detection method to the routine microbial susceptibility tests run in Syrian hospitals in order to determine and isolate the sources of MDR infections and do some effort to contain and eliminate those strains.