Urinary tract infection (UTI) is one of the most common domiciliary and nosocomial bacterial infections prevalent in both males and females. UTI is diagnosed on the basis of clinical symptoms, microscopy and culture of urine. In order to evaluate the efficacy of microscopic detection for presumptive diagnosis of UTI we analyzed urine samples of Nepalese patients. We have conducted Gram staining and counting of pus cells, red blood cells (RBC) and epithelial cells. We observed that RBC and epithelial cell counts were not sensitive enough to be used for presumptive diagnosis of UTI. However, pus cell counts as well as Gram stain are sensitive and significant enough to presume UTI. When the Gram stain result was compared with the culture result, it was statistically significant. From this, we suggest that Gram stain of centrifuged urine is a very sensitive screening method to detect bacteriuria. In addition, we found that E. coli was the most predominant microorganism causing UTI and nitrofurantoin was the most effective antibiotic against the isolated urinary pathogens.