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The nosocomial pathogen <i>Pseudomonas aeruginosa</i> (<i>P. aeruginosa</i>) is characterized by increased prevalence in hospital wastewater and is a public health concern. Untreated wastewater severely challenges human health when discharged into nearby aquatic ecosystems. The antibiogram profiles and resistance genes of <i>P. aeruginosa</i> were evaluated in this study. Wastewater effluents were obtained from a hospital within a six-month sampling period. After the samples were processed and analysed, <i>P. aeruginosa</i> was identified by polymerase chain reaction (PCR) by amplifying <i>OprI</i> and <i>OprL</i> genes. The Kirby–Bauer diffusion technique was employed to check the susceptibility profiles of <i>P. aeruginosa</i> which were further interpreted using CLSI guidelines. A total of 21 resistance genes were investigated among the isolates. The sum of 81 positive <i>P. aeruginosa</i> were isolated in this study. This study’s mean count of <i>Pseudomonas aeruginosa</i> ranged from 2.4 × 105 to 6.5 × 105 CFU/mL. A significant proportion of the isolates were susceptible to imipenem (93%), tobramycin (85%), norfloxacin (85%), aztreonam (70%), ciprofloxacin (51%), meropenem (47%), levofloxacin (43%), and gentamicin (40%). Meanwhile, a low susceptibility was recorded for amikacin and ceftazidime. The overall multiple antibiotics resistance index (MARI) ranged from 0.3 to 0.9, with 75% of the multidrug-resistant isolates. The assessment of β-lactam-resistant genes revealed <i>bla_OXA-1</i> (3.7%) and <i>bla_SHV</i> (2.4%). The frequency of carbapenem genes was 6.6% for <i>bla_IMP</i>, 6.6% for <i>bla_KPC</i>, 6.6% for <i>bla_oxa-48</i>, 2.2% for <i>bla_NDM-1</i>, 2.2% for <i>bla_GES</i>, and 2.2% for <i>bla_VIM</i>. Of the aminoglycoside genes screened, 8.6% harboured <i>strA</i>, 11.5% harboured <i>aadA</i>, and 1.5% harboured <i>aph(3)-Ia(aphA1).</i> Only one non-β-lactamase gene (<i>qnrA</i>) was detected, with a prevalence of 4.9%. The findings of this study revealed a high prevalence of multidrug-resistant <i>P. aeruginosa</i> and resistance determinants potentially posing environmental health risks.