Summary: Pregnant women, compared to non-pregnant women, have as much as a 4-10 times increased risk of urinary tract infection (UTI), which is one of the most common bacterial diseases found in pregnant women. URI in pregnancy can be divided by the level of infection - lower urinary tract infection, or asymptomatic bacteriuria and acute cystitis (UTI), and upper urinary tract infection, or pyelonephritis (UTI). In 2024, guidelines common to three scientific societies (the Polish Urological Society [PTU], the Polish Society of Gynecologists and Obstetricians [PTGiP] and the Polish Society of Family Medicine [PTMR]) for the diagnosis, therapy and management of out-of- -hospital lower urinary tract infections appeared, on which this article is largely based. Anatomical and physiological changes in pregnancy contribute to urinary stasis, facilitating colonization with urinary tract bacteria. Among the pathogens causing URI in pregnant women, as in the general population, Escherichia coli predominates, accounting for 70-80% of infections. Both bacteriuria and URI are obligatorily treated in pregnancy. Bacteriuria is diagnosed on the basis of a urine culture taken from the midstream, when the titer is a minimum of 105 CFU/ml of bacteria. Treatment is based on antibiotic therapy according to the drug susceptibility result. Alarmingly, an increasing trend of amoxicillin resistance of E. coli bacteria has been observed (up to 45% in Poland). Therefore, changes in the recommendations mentioned in the introduction were inevitable: amoxicillin and ampicillin are no longer first-line drugs. To date, E. coli bacteria have not been found resistant to fosfomycin and pivmecillinam. Untreated URI can lead to serious complications for the pregnant woman and the fetus. Hospitalization is unavoidable in the case of pregnant women with URI. Parenteral antibiotic therapy should be used until clinical improvement is achieved.