A prospective study was conducted at the Liaquat National Hospital and Medical College, Karachi, to determine the effectiveness, feasibility, and safety of intravesical Gentamicin therapy among patients presenting with recurrent urinary tract infections (rUTIs). All patients aged ≥15 years, who presented with recurrent UTI, having ≥3 positive urine cultures, with neurogenic bladder, intermittent catheterisation, symptomatic UTIs, and multidrug resistant cultures, were included in the study. Data were compiled and analysed using SPSS version 26. An ethics committee approved the study. A total of 69 patients were enrolled. Most common organisms were Klebsiella (52.2%), E. coli (27.5%) and gram -ve bacilli (14.5%). Multi drug resistance was observed in 18 (26.1%) patients, while effectiveness and safety were reported in 62 (89.9%) and 65 (94.2%) patients, respectively. Intravesical Gentamicin may be helpful in reducing the frequency of episodes and need for oral antibiotics in patients with UTIs, and demonstrated effectiveness and safety in most patients.