Pseudomonas aeruginosa infections in pediatric units are redoubted because of their high level of morbidity and mortality and the increased risk of therapeutic failure. Our aim was to access the profile of antibiotic resistance among P. aeruginosa isolats and guide the choice of an adapted antibiotic therapy against P. aeruginosa pediatric infections. A descriptive study has been conducted over a period of 4 years at the Mother - Child department of the University Hospital of Marrakech (Morocco). 168 stains of P. aeruginosa were isolated. P. aeruginosa infections were frequently occurred on an immunosuppression context. Specimens were dominated by pus (29.7%). P. aeruginosa bacteremia represented 20.8%. Multidrug-resistant P. aeruginosa stains (MDR) has represented 25.6% of all isolates. The highest rate of multidrug resistance has concerned pediatric and neonatal intensive care units (66.1%). The most active antibiotics were amikacin, imipenem, and ciprofloxacin. The cephalosporinase phenotype conferring resistance to ceftazidime was involved in 15 % of the strains. The imipenemase phenotype conferring resistance to all beta-lactams has concerned 4.7% of isolates. The antibiotic combinations piperacillin/tazobactam-amikacin has been chosen as an empirical antibiotic therapy against invasive P. aeruginosa infections in pediatric units. This study showed a high frequency of multidrug resistant P. aeruginosa in pediatric intensive care units. Monitoring of local epidemiology and antibiotic resistance of P. aeruginosa is fundamental to guide the clinicians to choose an appropriate antibiotic therapy.